community health assessment

Transcription

2010
COMMUNITY
HEALTH
ASSESSMENT
Acknowledgements
The 2010 Community Health Assessment report was prepared by Lee County
Public Health Assessment Team and LeeCAN “A Healthy Carolinians
Partnership”
Lee County Public Health Assessment Team
Sandra Boyd, Health Education Supervisor
Linda Higgins, LeeCAN Coordinator
Pamela Glover, Health Education Specialist
Elsie Ramsey, Public Health Educator Intern
Wendy Seymore, NC Dental Hygienist assigned to Lee County
Howard Surface, Health Department Director
LeeCAN “A Healthy Carolinians Partnership” Assessment Team
Charles Sutherland, LeeCAN Co-Chairperson, Concerned Citizen
Sandra Coombs, LeeCAN Co-Chairperson, Parish Nurse Crossroads Ministries
Brandi Phillips, LeeCAN Secretary, Lee County Parks and Recreation
Pam Glover, LeeCAN Teen Pregnancy Task Force Chairperson, Health Educator
Lee County Public Health Department
Brittany McBryde, LeeCAN Teen Pregnancy Task Force, Coalition for Families in
Lee County
Marilyn Gilliam, LeeCAN Access to Mental Health Task Force Chairperson, VC &
Associates
Laura Biediger, LeeCAN Obesity Task Force Chairperson, Communities In
Schools
Bill Stone, LeeCAN Obesity Task Force, NC Cooperative Extension
ii
Community Health Assessment Listening Session Moderators/Facilitators
Annie Lanier McIver, Cameron Grove AME Zion
Mary B. Oates, Lee County Schools
Laura Biediger, Communities In Schools
Kate Nelson, Lee County Schools Student Intern
Josie Ceves, Lee County Schools Student Intern
Marvin Morris, Concerned Citizen
Karen Brown, Karen Brown ERA Realty
Brandi Phillips, Lee County Parks and Recreation
Marilyn Gilliam, VC & Associates
Jan Hayes, United Way of Lee County
Michele Bullard, United Way of Lee County
Pamela Glover, Lee County Public Health
Elsie Ramsey, Lee County Public Health Intern
Sandra Boyd, Lee County Public Health
We would like to thank Elsie Ramsey, Public Health Educator Intern and other
faculty with the University of North Carolina at Greensboro who assisted with the
2010 Community Health Assessment Survey and Listening Session data
collection and analysis.
Special thanks to Emily Tyler, retired Health Educator and Pam Patterson, retired
Lee County Schools Director for their diligent proofing of the document.
Thank you to the residents of Lee County, LeeCAN Assessment Committee, the
Healthy Carolinians partners and member agencies who helped to guide this
process.
Photos by Sanford Herald Newspaper, Jimmy Haire Photography, Central
Carolina Hospital, Lee County Parks and Recreation, Temple Theatre, Lee County
Pottery Festival, Lee County Instruction Technology Department, and Lee County
Economic Development
iii
LeeCAN Partners
Cameron Grove AME Zion Church
Center for Behavioral Healthcare
Central Carolina Community College
Central Carolina Hospital
Church of New Deliverance
Coalition for Families
Communities In Schools (CIS)
Concerned Citizens
Crossroads Ministries/Parish Nurse
DayMark Recovery
ERA Strother Realty
ESquare Community Service
Fair Promise AME Zion Church
Family Connextions
Haven
HomeTown News Magazine
Honor1spirit
Kaleidoscope
Lee County Department of Social Services
Lee County Industries, Inc.
Lee County Parks & Recreation
Lee County Partnership for Children
Lee County Public Health & LeeCAN
Lee County Schools
Lee County Senior Services
iv
Lee County Sheriff's Office
NC Department of Cooperative Extension
NC Division of Public Health/ Oral Health Section
Project Reclamation
Reach Out Crisis Center
Sandhills Center LME Family Support
Sanford City Government
Sanford City Police
Sanford City Public Works
Sanford Herald
Sanford Housing Authority
Stevens Center
The Family Doc Counseling Center
United Way of Lee County
VC & Associates
WFJA/WWGP 105.5FM/1050AM
WLHC 103.1 FM
WXKL 1290 AM
YMCA
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2010 Lee County Community Health Assessment
Table of Contents
Introduction .............................................................................................. 9
Methodology .................................................................................. 10
Data Collection and Analysis ......................................................... 10
Data Limitation............................................................................... 11
Chapter One - Community Health Profile ................................................ 12
Geographical ................................................................................ 13
Demographics .......................................................................... 14-23
Community Assets.................................................................... 23-27
Chapter Two – Changes since 2006 Community Health Assessment .... 28
Update ........................................................................................... 29
Access to Mental Health ........................................................... 29-30
Obesity ..................................................................................... 30-31
Teen Pregnancy ....................................................................... 31-32
Chapter Three –2008 Lee County Top Ten Leading Causes of Death ... 33
Background – Leading Causes of Death ....................................... 34
Heart Disease ................................................................................ 35
Cancer ...................................................................................... 36-37
Cerebrovascular Disease ......................................................... 37-38
Chronic Lower Respiratory Disease ......................................... 38-39
Diabetes Mellitus ...................................................................... 39-41
Motor Vehicle Injuries ............................................................... 41-42
Alzheimer’s disease.................................................................. 42-43
Nephritic Syndrome .................................................................. 43-44
Assault (homicide) ................................................................... 44-45
vi
Chronic Liver Disease and Cirrhosis ........................................ 45-46
Life Expectancy and Uninsured Rates …………………………. 46-47
Chapter Four– Lee County 2010 Community Health Assessment Results….48
Background ................................................................................... 49
Aging Problems ........................................................................ 49-50
Cancer ........................................................................................... 50
Dental Health ................................................................................. 51
Diabetes ........................................................................................ 52
Heart Disease/Heart Attacks .................................................... 52-53
Hypertension/High Blood Pressure........................................... 53-54
Mental Health ........................................................................... 54-55
Obesity/Overweight .................................................................. 55-56
Sexually Transmitted Infections ................................................ 56-57
Teen Pregnancy ....................................................................... 57-58
Priority Setting .......................................................................... 58-59
Top 10 Identified Health Concerns ................................................ 59
Emerging Issues ....................................................................... 59-60
Changing Demographics ............................................................... 60
Technology .................................................................................... 61
Infectious Diseases ....................................................................... 61
Transportation ............................................................................... 62
Youth Violence and Crime ............................................................ 62
Opinion Survey Results ............................................................ 63-73
Listening Session Results ........................................................ 74-80
Chapter Five – Health Resources ........................................................... 81
Inventory of Existing Health Resources ......................................... 82
Comparative Data..................................................................... 82-84
vii
Health Resources ..................................................................... 85-97
Conclusions Drawn........................................................................ 98
Chapter Six – Community Health Assessment Dissemination ................ 99
Publication ................................................................................... 100
Presentations............................................................................... 100
Dissemination ....................................................................... 100-101
Chapter Seven – Conclusions and Next Steps ..................................... 102
Community Action Planning ........................................................ 103
Appendices ........................................................................................... 104
A. Moderator Facilitator Training .......................................... 105-107
B. CHA Priority Meeting ........................................................ 108-110
C. CHA Partner List ..................................................................... 111
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2010 Lee County
Community Health Assessment
INTRODUCTION
The Lee County Health Department and Lee
Community Action Network (LeeCAN) “A Healthy
Carolinians Partnership” are pleased to present the
2010 Community Health Assessment. The State of
North Carolina requires local health departments and
local Healthy Carolinians Partnerships to submit a
Community Health Assessment document every four
years.
A Community Health Assessment (CHA) is a process
by which community members gain an understanding
of the health concerns and health-care systems of the
community by identifying, collecting, analyzing, and
disseminating information on community assets,
strengths, resources, and needs. This is
accomplished by using a compilation of state and
local statistical data (primary sources) collected
through a community health survey and “Listening
Sessions.” Other information sources, i.e., secondary
sources, also were used. It is our hope that the
information outlined in this report accurately
represents the county’s strengths and needs.
Lee County supports Lee Community Action Network
(LeeCAN) “A Healthy Carolinians Partnership” that
has been in existence for thirteen years. Healthy
Carolinians is a “network of public-private
partnerships across North Carolina that share the
common goal of creating environments that promote
healthy life styles for all North Carolinians.” The local
partnership consists of members of the public as well
as representatives from agencies and organizations
that serve the health and human service needs of the
local community, businesses, faith-based
organizations, schools, and civic groups. LeeCAN
has been instrumental in assisting with the
Community Health Assessment by handing out
surveys, participating in and facilitating Listening
Sessions, determining health priorities, and
researching community needs. For more information
about LeeCAN or NC Office of Healthily Carolinians,
please visit the following websites:
www.leecountync.gov or
http://www.healthycarolinians.org/.
9
Accreditation Standards
This report insures The Lee County Health
Department is meeting one of the key
assessment standards instituted as a part of
the North Carolina Local Public Health
Accreditation Program.
This program was established to develop a
mandatory, standard-based accrediting
system for local health departments across
the state.
The Local Public Health Accreditation
Program is a collaboration of the North
Carolina Division of Public Health, the North
Carolina Association of Local Health Directors
and The North Carolina Institute for Public
Health. Lee County will seek its Accreditation
status in the year 2012.
Essential Function: Assessment
Essential Services:
*Monitor health status to identify community
health problems.
*Inform, educate, and empower people about
health issues.
*Mobilize community partnerships to identify
and solve health problems.
*Research for new insights and innovative
solutions to health problems.
Standard 1:
Conduct and disseminate results of regular
community health assessments to monitor
progress
2010 Lee County
Methodology
Efforts to compile the 2010 Lee County Community Health Assessment (CHA) began in October
2009 with the formation of the CHA steering committee which included co-chairs of LeeCAN;
co-chairs of the LeeCAN subcommittees; members of the partnerships recruited as moderators,
facilitators, and recorders; and representatives from Lee County Public Health. The members of
the partnerships and the assessment team gathered and analyzed information from multiple
sources to insure that the issues and needs identified in this document represent the citizens of
Lee County. The sources of information used were 1) Community Health Assessment Survey
and 2) Listening Sessions.
Data Collection & Analysis
Listening Sessions are designed to allow participants to collectively communicate opinions and
feelings, thus enabling observers to understand the attitudes and beliefs that influence
behaviors, and to gather data about the environmental and policy factors that affect health. The
questions were designed to determine perceptions about county health issues that affect the
quality of life for senior citizens and youth; the state of environmental health; crime and safety;
and overall strengths, weaknesses, obstacles, and needs.
Listening Session participants usually are familiar with one another and already comprise a
group. CHA members were recruited from organizations and agencies. Thirteen of those
volunteers received training as facilitators, moderators, and recorders, and conducted eight
Listening Sessions which targeted a total of ninety people. These approximately one-hour
sessions were held in February, 2010 and centered on several specific, open-ended questions.
In each Listening Session there was one moderator and two recorders. (See Chapter Four.)
The survey was used to identify what community members think about their health status and
their community. The Community Health Assessment survey was developed by the NC Office
of Healthy Carolinians. The Lee County Community Health Assessment team was able to edit,
format, and translate the document into Spanish. The survey was composed of 44 questions
and was distributed throughout the month of January, 2010. The survey was divided into five
general areas designed to gather a comprehensive picture of community health in Lee County.
These areas included quality of life in Lee County, community problems and issues, personal
health, emergency preparedness, and demographics.
Over 600 surveys were distributed in English and Spanish. Participants were asked to return
the surveys by February 28, 2010. The collected surveys were then entered into the Statistical
Package for the Social Sciences (SPSS) data collection system and analyzed. SPSS allows the
analyst to examine statistics and data management in depth, including case selection, file
reshaping, creating derived data, and data documentation, and to analyze, display, and predict
trends and correlations. SPSS was used to analyze all the data from the CHA surveys and to
create graphs and tables included in the Health Assessment.
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2010 Lee County
Data Limitation
Most of the health statistics in this report were obtained from the State Center for Health
Statistics, NC CATCH (Comprehensive Assessment for Tracking Community Health), US
Census, 2000 Census, and 2005 and 2006 American Community Surveys. When data from
Lee County and the state of North Carolina are compared, the 2003-2008 years were used
because data from the County Health Data Book is comparable in periods, age adjusted, and in
consecutive years. Comparable morbidity data were found in the 2003 - 2008 periods and were
therefore used.
The State Center for Health Statistics states the following about its data:
Rates presented here utilized population estimates from the North Carolina State
Demographer’s Office. Population estimates are periodically modified based on the best
available information. Therefore, rates presented in this report may vary over time as revised
population estimates become available. Data may include revisions and therefore may differ
from data previously published in this report and other publications.
There may be participant bias regarding qualitative data obtained during the Listening Sessions.
The responders may have answered questions in a way that he or she thought would sound
better or in a way that the interviewer would view as favorable.
The Community Health Assessment Survey may have a response bias. Those who answered
the survey may have characteristics such as motivation, educational background, or concern for
the community different from the characteristics of those who did not respond. This data report
should be viewed with the errors and limitations kept in mind.
11
2010 Lee County
CHAPTER
ONE
COMMUNITY
HEALTH
PROFILE
12
2010 Lee County
CHAPTER ONE
Community Profile
Geographical
Lee County, the 98th county established in NC, is situated in the geographic center of the state
dividing the Piedmont and the Coastal Plain. According to the US Census Bureau Lee County
has a total area of 259 square miles of which 257 are land and two are water. Lee County is
comprised of eight townships: Greenwood, Jonesboro, Cape Fear, Deep River, East Sanford,
West Sanford and Pocket. The only incorporated towns, Sanford and Broadway, are found
within the townships of Sanford and Cape Fear respectively. Lee County was established in
1907 from portions of Moore and Chatham Counties. Lee County is adjacent to Chatham
County on the north, Harnett County on the southeast and Moore County on the southwest.
Lee County was named for Robert E. Lee, commanding general of the Confederate forces
during the American Civil War.
Lee County is located at the base of the Research Triangle Region (Raleigh, Durham, and
Chapel Hill). Other cities in close proximity include Greensboro, Winston-Salem, High Point,
Salisbury, Albemarle, Pinehurst, Fayetteville, and the Fort Bragg community. Fort Bragg is a
huge asset to Lee County because of its geographic location.
DEEP RIVER
WEST
SANFORD
EAST
SANFORD
POCKET
JONESBORO
GREENWOOD
13
CAPEFEAR
2010 Lee County
Demographics
The following table shows the population of Lee County based on 2009 Census
estimates. The county has a greater proportion of younger and older populations than
the state overall and a much larger percentage of Hispanic/Latinos.
Table 1: Lee County population compared with the state, 2009
North Carolina
Lee County
9,380,884
60,477
Percent of Females
51.1%
50.5%
Percent of Males
Percent Under 5 Years of Age
Percent Under 18 Years of
Age
Percent of 65 Years of Age
and Older
Percent of Whites
Percent of African Americans
Percent of Asian/Pacific
Islanders
Percent of Hispanic/Latinos*
Percent of Native Americans
Source: US Census, 2009 Estimates
48.9%
7.0%
20.2%
49.5%
7.9%
21.0%
12.2%
14.0%
70.3%
21.2%
2.3%
66.1%
20.0%
1.1%
Population
7.0%
15.8%
1.1%
0.3%
*Included in other races
Table 2: Lee County Income Levels, 2006-2008
Income Level
Less than $25,000
$25,000 to $50,000
$50, 000 to $79,000
$75,000 to $99,000
$100,000 to 200,000
$200,000 or More
Median Household Income
Households
5,874
5,944
4,066
2,479
2,617
124
$43,046
% of Households
27.8%
28.2%
19.3%
11.7%
12.4%
0.6%
Source: US Census 2006-2008, American Community Survey
Table 3: Lee County Poverty Rates, 2006-2008
Group
All Individuals
Under 18 Years of Age
Related Children Under 5
Years
Related Children 5 to 17
Years
18 to 64 Years
65 Years and Over
# of Persons
8,171
2,979
905
% of Persons
14.3%
5.2%
1.6%
2,074
3.6%
4,399
466
7.7%
0.8%
Source: US Census 2006-2008, American Community Survey, 3 year Estimates
14
2010 Lee County
Table 4: School Age Children Poverty Level
Year
Free and Reduced Lunch
Percentages
54.94%
55.81%
55.39%
57.90%
2006
2007
2008
2009
Source: LCS Free and Reduced Lunch Report
*As of 5/2010 the percentage of free and reduced lunch is 60.25% and that
figure changes as the school system receives applications or students transfer, enter, or withdraw.
Child Care
Programs for child care in Lee County are administered through the collaborative efforts of the
Lee County Partnership for Children (LCPFC) and the Coalition for Families Child Care
Resource and Referral (CCR&R). CCR&R offers information to parents searching for child care
and provides technical assistance and training for child care providers. LCPFC offers assistance
with professional development, quality enhancement grants, and the More at Four program as
well as providing technical assistance to child care providers. For Lee County there are 77
licensed child care facilities, which employ approximately 344 teachers (in 39 family child care
homes & 38 child care centers).
For Lee County parents seeking child care, affordability of child care services is the main
problem they face. As of May 2010, there were 200 families on a waiting list for the child care
assistance program administered by the Department of Social Services; however, the number
changes from week to week. Many parents working at lower-wage jobs may be paying one third
to one half their incomes to cover child care costs. Lee County’s double-digit unemployment
rate has caused many parents to take their children out of child care to save money.
CHILD CARE QUICK FACTS ABOUT LEE COUNTY
Average weekly cost of child care in centers
Average weekly cost of child care in Family Child Care Homes
Average starting pay for assistant teachers
Average starting pay for lead teachers
Average starting pay for lead teachers with 2 yr. degree
Average starting pay for administrators
Yearly income for family home providers
$134
$110
$7/hr
$8/hr
$9/hr
$10/hr
$22,000
Source: Child Care Resource & Referral (CCR&R) – Coalition for Families in Lee County 2010
Crime and Selected Indicators
Offense
Category
Murder
Rape
Robbery
AA*
Burglary
Larceny
MV T*
Total
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
7
16
72
132
844
1,990
171
3,232
2
13
57
82
620
1,280
132
2,186
3
15
68
108
891
2,127
116
3,328
8
15
89
109
982
2,098
182
3,483
6
23
101
95
834
1,924
152
3,135
3
13
75
115
779
1,489
176
2,650
6
14
68
76
595
1,441
170
2,370
3
16
72
60
655
1,418
176
2,400
6
12
66
72
699
1,205
153
2,213
9
8
64
85
581
1,144
166
2,057
Source: http://www.sbi.jus.state.nc.us/crp/public *Rates are based on per 100,000 (* Aggravated Assault; *Motor Vehicle Theft)
15
2010 Lee County
Economy
Lee County is geographically located at the southern base of the Research Triangle Region,
including the cities of Raleigh, Durham, and Chapel Hill. Major industries, including ten Fortune
500 companies, are located within the government’s boundaries or in close proximity. These
include manufacturers of pharmaceuticals, automobile components, cosmetics, plumbing
fixtures, electronics, and brick making.
Through the combined efforts of excellent county and city leadership and organizations such as
the Lee County Economic Development Corporation, the Lee County Committee of 100, and the
Sanford Area Chamber of Commerce, the county’s economic base continues to expand.
Red Wolf, a contract manufacturer, recently received a new contract and is expanding their
operations. American Energy Power On Demand (EPOD) and Cameron Testing Services each
received a $75,000 grant for the USDA Rural Center. Frontier Spinning Mills is adding new
equipment to their yarn spinning plant. Score Energy is adding additional space and jobs.
The retail and service industry continues to grow along with our population. Our hotels and
restaurants enjoy the influx of people visiting Lee County during the annual pottery festival and
other downtown festivals. The City of Sanford is becoming a destination for the pottery industry
and other artists in jewelry, stained glass, woodworking and painting. New showrooms are
open in the downtown area, all with art created in Lee County. Lee County boasts a golf course
called Tobacco Road which was designed by Mike Strantz and is ranked eighth in the country
according to the GolfLink Top 100 United States Golf Courses. There are also two Robert Trent
Jones, Jr. courses at Carolina Trace.
Top Manufacturers by Number of Employees
Pilgrim’s Pride (poultry processing)
Pfizer (pediatric vaccines)
Coty Inc. (cosmetics & perfume)
Static Control (electronics & industrial equipment)
Tyson Foods (Mexican food products)
Moen Inc. (plumbing fixtures)
Pentair Water, Pool & Spa (filters & pumps)
Arden (components for outdoor furniture)
Caterpillar (compact construction machines)
Frontier (yarn)
1,100
880
875
850
520
430
420
384
336
300
Education
Lee County Schools is governed by an elected seven-member board overseeing 16 schools
pre-K through 12th grade with approximately 9661 students. There are six traditional elementary
schools; one year-round choice elementary school, three middle schools, two traditional high
schools, one early college high school, one alternative school, one exceptional education
school, and one child development center. Lee County Schools is supported by 1307
employees and an $85 million budget. In addition, Lee County also has three private K-12
schools and one Montessori school.
16
2010 Lee County
Student Enrollment/Student Diversity
Enrollment 2009-2010
Number of Students in K-12
Kindergarten – Grade 5
Grades 6-8
Grades 9-12
Pre-Kindergarten
Diversity Among the Students
American Indian/Multi racial
Asian
African-American
Hispanic
White
Native languages spoken by
students
Number
9,661
4,647
2,153
2,861
226 (not in total)
5.1%
<1%
22.6%
26.4%
45%
24
Source: Lee County Schools
In comparison to the ethnic makeup of the county, the racial composition of the district's full-time
personnel is 13% African-American; 83% White; and 4% Hispanic. Personnel composition of
Lee County Schools (full time) is not reflective of the composition of its students. This disparity
has long been an issue for the county, and targeted efforts are being made to recruit minority
personnel.
Students’ Continuing Education in 2009
Seniors accepting scholarships to further their
education in college
Amount of scholarships accepted
Overall Grade Point Average of graduating seniors
North Carolina Academic Scholars
Future Plans
Percent of students planning to continue their
education in college
Percent of students planning to enter military
Percent of students planning to enter the workforce
154
$2,416,936
2.81
69
81.29%
5.32%
11.82%
The 2009 classes of Lee Senior High School and Southern Lee High School graduated 594
students, many of whom attained notable achievements during their high school careers.
AYP/ABC Comparison Results 2008-2009
District
Lee
Chatham
Harnett
Moore
Wake
State
% Making Growth
92.8
87.5
82.6
87.5
87.9
67.1
17
% Meeting AYP Goals
73.3
69.8
53.8
71.5
62.8
71.0
2010 Lee County
Lee County Schools continues to rank the highest of the neighboring counties in the percent of
students who are making growth on the End of Grade/End of Course tests (state ABC
Accountability) which are given to students in grades 3-12. Lee County Schools also ranks first
compared to neighboring counties in meeting federal Adequate Yearly Progress (AYP)
indicators. The elementary students are doing well on these instruments, and multiple initiatives
are in place to improve the performance of secondary students.
2008-2009 SAT (Scholastic Aptitude Test)
Math
Lee County High
School
Southern Lee
High School
Lee County
Schools
All NC Students
Critical
Reading
Writing
Math + Critical
Reading
511
490
474
1001
496
477
452
973
505
485
465
990
511
495
480
1006
Lee County Schools are below the state in the composite score for SAT. Improvement plans
are evolving to help boost scores.
Lee County Educational Attainment Levels, 2006-2008
Group
Population 25 Years and Older
th
Less than 9 Grade
th
th
9 -12 Grade, no diploma
High School graduate (includes
equivalency)
Some college or associate degree
Bachelor’s Degree
Master’s, professional or doctoral degree
Population
37,769
3,449
4,981
11,718
Percentage
11,674
4,229
1,718
30.9%
11.2%
4.5%
9.1%
13.2%
31.0%
Source: US Census 2006-2008, American Community Survey
Demographic data reflect a decade-long trend illustrating a growing student population,
increasing student diversity, and greater numbers of students receiving free and reduced lunch
benefits. Student membership has increased from 8831 students during the 2000-2001 school
year to 9661 students during the current school year. The greatest demographic change since
2000 has been the increase in the Hispanic student population from 11.9% of student
membership to 26.4% of student membership. Approximately 10% of the students qualify for
Exceptional Children services.
Dropout Rate
A total of 148 students, 4.97%, in grades 9 through 12 dropped out of school in 2007-08. In
2008-09, 172 students, 5.83%, dropped out. In 2009 Lee County was recognized for being one
of five counties with the largest three-year change in dropout rates with a reduction of 82
students since the 2005-06 school year. Lee County’s dropout rate equals the state’s rate
which saw the first decrease in three years.
Lee County Schools is among 66 of North Carolina’s 115 school districts reporting a decrease in
dropouts. This year’s dropout rate of 4.97 % gives Lee County Schools a ranking in the top half
of school districts in the state. This rate continues a positive trend from three years ago when
18
2010 Lee County
Lee County had the third worst dropout rate in the state at 7.8%. The 2009-2010 dropout rate is
unavailable at this time.
In Lee County, male students make up the highest percentage of dropouts with 63.5 % of the
total number, compared to a female percentage of 36.5. When analyzing ethnicity, white
students account for the highest percentage of the dropout count at 53.4%; black students
account for 22.3%; and Hispanics students account for 20.3%. The percentage of black and
Hispanic dropouts fell in 2007-08, with the percentage of the total dropout count for black
students falling by 11.4 percentage points. Over two years, the white dropout rate has been
reduced by 29%, the black dropout rate has been reduced by 43%, and the Hispanic dropout
rate has been reduced by over 56%.
Academic Initiatives
Lee County Schools is committed to providing students with 21st century education and
positioning them for success. Lee County Schools is expanding the Science, Technology,
Engineering, and Math programs for middle and high schools. An emphasis on technology has
provided state-of-the-art teaching tools for the classrooms. E-Lee Academy, a distance learning
program, offers students the opportunity to gain college credit as they work toward high school
graduation. There is also an active Communities In Schools program.
Higher Education
There are numerous opportunities for Lee County residents to further their education. Lee
County is fortunate to have the main campus of Central Carolina Community College (CCCC)
located in Sanford. Additional CCCC sites are in Pittsboro and Siler City in Chatham County and
Lillington in Harnett County. CCCC’s main campus is located on a 41-acre site on Kelly Drive
off Nash Street near U.S. Highway 421 (east), Sanford, and has 177,000 square feet of class
room, shop, and laboratory space. Ample equipment, a large Learning Resource Center, and an
efficient staff provide optimum training in a variety of adult programs.
Civic Center
The Dennis A. Wicker Civic Center opened in May of 1991 with an award-winning design. It was
named for local resident Dennis A. Wicker whose family has a history of political service to the
county and state. He held several political positions and is a former state Lieutenant Governor.
Proud of its namesake, the facility is host to a variety of educational, social, and civic events
throughout the year.
Strategically located in Sanford, the heart of North Carolina as well as Lee County, the Center is
accessible by major highways in all directions. In addition to meeting and conference rooms, the
Center has an exhibition hall that dominates the facility. With a seating capacity of over 1,400
and a large stage, the area is suitable for concerts, pageants, speakers, and conventions.
Divided into four meeting quadrants, the area may be used for workshops and planning
sessions or for smaller banquets, social gatherings, annual dinners, and award presentations.
19
2010 Lee County
Colleges and Universities
There are several four-year colleges and universities located within 100 miles of the county.
Bennett College
Campbell University
Duke University
Fayetteville State University
Guilford College
High Point University
Meredith College
Methodist University
NC A &T State University
North Carolina Central University
North Carolina State University
Peace College
Pembroke State University
Shaw University
St. Augustine’s College
University of North Carolina-Chapel Hill
University of North Carolina-Greensboro
Environmental Health
Water Quality
The City of Sanford built the water treatment plant in 1970. The plant capacity of six million
gallons per day was reached in 1991 and required an upgrade to the current capacity of twelve
million gallons per day to accommodate the growth experienced in Sanford and Lee County.
The water treatment plant serves the City of Sanford, Lee County including Carolina Trace and
the Town of Broadway, and sections of Chatham County, including the Town of Goldston/Gulf.
Customers are fortunate to have an abundant water supply from a single-surface water source,
the Cape Fear River. Water is pumped from the Cape Fear River into a sixty-million gallon
reservoir. The reservoir holds a ten-day supply of water, and provides presettling resulting in
higher water quality, reducing chemical and energy costs.
The plant houses a state-certified laboratory that conducts hundreds of tests daily for water
quality. In addition to testing the water at different stages through the process, laboratory
personnel test the water at fifty sites monthly throughout the distribution system. The plant
affords an abundant and reliable supply of drinking water for our customers.
Air Quality
State and local air quality programs issue air quality forecasts for ozone from April through
October in the Asheville, Charlotte, Fayetteville, Hickory, Triad and Triangle, and Rocky Mount
metropolitan areas. Sanford falls within the Triangle and Fayetteville areas. Air quality in
Sanford tends to be better because usually the larger metropolitan areas have more industry,
cars and trucks which increase emissions in the air and affects the ozone levels.
Ozone is a highly reactive form of oxygen and can be unhealthy to breathe, particularly for
children, people with respiratory problems or heart disease, and even healthy adults who work
or exercise outdoors. Exposure to high ozone levels may cause previously healthy individuals
to develop asthma over time. The ozone levels are (1) green indicates good; no health effects
are expected; (2) yellow indicates moderate; usually sensitive people should consider limiting
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prolonged outdoor exertion; (3) orange indicates unhealthy; sensitive groups, active children
and adults with respiratory disease, such as asthma, should limit prolonged outdoor exertion;
(4) red indicates unhealthy; active children and adults and people with respiratory disease,
such as asthma, should avoid all outdoor exertion; everyone else, especially children, should
limit prolonged exertion, and (5) purple indicates very unhealthy; active children and adults
and people with respiratory disease such as asthma, should avoid all outdoor exertion;
everyone else, especially children, should avoid prolonged outdoor exertion.
The ozone in Sanford/Lee County is usually good to moderate; however, Chronic Lower
Respiration disease is listed as the fourth leading cause of death for Lee County in 2008.
Therefore, persons at risk need to be aware and take precaution as necessary.
Lead Poisoning
In 2008, one child was reported for elevated blood lead levels (≥ 10ug/dL). There was no
reported confirmed elevated blood lead levels ≥ 20ug/dl for 2008. Investigations are required for
confirmed cases of elevated blood lead levels in children by the North Carolina Division of Child
Health, but the parent/guardian can refuse to cooperate. The Child Health Nurse and
Environmental Health staff offer educational materials to parents/guardians of children with
elevated blood lead levels and provide content concerning dietary needs, hand washing, and
good meal time and snack time practices.
Faith-Based Organizations
Faith and spirituality play a significant role in the health and well-being of many Lee County
individuals and families. There are over one hundred Christian churches of all denominations in
Lee County. Faith-based organizations are involved in numerous ministries that include after
school programs, child care centers, food pantry, mentor programs, parish nursing as well as
health ministries.
Health Services
For detailed information on the Health Services in Lee County see Chapter Four, Inventory of
Existing Heath Resources.
Public Health Preparedness
The Lee County Health Department has a section dedicated to the protection and well-being of
the residents of Lee County. The Public Health Preparedness Section assists emergency
response departments with specialized needs and provides detailed planning procedures for
incidents requiring multi-agency participation. Below are some of the issues that the Lee
County Public Health Preparedness Section is currently addressing.
The H1N1 Pandemic was and still is the pressing issue for many citizens of Lee County, and the
Public Health Preparedness Section worked diligently with the state and local partners to insure
the H1N1 vaccine was available in as many areas as possible in the county. Lee County
partnered with 27 different businesses in the county. The Lee County Health Department and
local businesses were able to immunize or have the vaccine available to all Lee County citizens.
It was and is still a tremendous cooperative agreement among our many partners.
Currently, the Lee County Preparedness Section is rewriting the Pandemic Flu Plan. It was
originally written in 2007. After the H1N1 Pandemic began, Lee County realized the Pandemic
Flu Plan needed to be revised. It has been completed and is being reviewed by this section and
will be printed in the near future.
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The Lee County Public Health Preparedness Section also dealt with the possible repatriation of
Haitians to this area after the earthquake in Haiti. Many hours were spent discussing the matter
with the state and other states as well and trying to understand the diseases prevalent in third
world countries and what the Standard Operating Procedures for the state and other states may
be. Meetings were held in Lee County with the Health Department staff to discuss the possible
scenarios, along with what vaccines the county would need for immunizations. At this point, no
Haitians have been repatriated to this county, but the Lee County Public Health Preparedness
Section is prepared should this occur.
The Strategic National Stockpiles (SNS) plan has been rewritten in the last few months. This
plan enables the Centers for Disease Control (CDC) to work hand-in-hand with the state and
local authorities to insure that Lee County receives the medicines, antidotes, and medical
supplies needed to respond to a wide range of unexpected problems or scenarios. The main
objective of the SNS plan is to describe how Lee County will request, receive, manage,
repackage, and distribute the SNS to those county residents who need it.
Senior Services
The mission of Lee County Senior Services is to provide a comprehensive assessment of the
needs and opportunities associated with older adults and to fashion an achievable vision of
successful aging in Lee County. Lee County Senior Services' mission statement is facilitated by
the Enrichment Center, a building which serves as a focal point in the community where older
adults meet to participate in activities and enhance their involvement in the community. The
Center was developed for the purpose of providing an activity center for older adults who can
function independently. It is a visible reminder in Lee County of the value and contributions of
older citizens. For more information see Chapter Four, Inventory of Existing Health Resources.
Services for Special Populations
Lee County is comprised of several agencies and facilities focusing solely on the care,
development, and well-being of individuals with mental, behavioral, and physical disabilities.
The day programs are staffed with well-trained individuals able to work one-on-one or in group
settings with clients on educational, work, and social skills. Along with day centers, there are
many residential homes staffed with trained personnel equipped to work with mentally and
physically disabled children, youth, and adults in personal care, work and social skills, and
home and money management with hopes of independent living in society.
Transportation
The County of Lee Transit System (COLTS) is a coordinated transit system that provides
transportation services for the general public and human service agencies in Lee
County. Passengers who are customers of a human service agency may contact the sponsoring
agency to reserve their ride. Qualifications vary among agencies in Lee County. For additional
information on the challenges of transportation as the demographics changes, see Chapter Four
under Emerging Issues.
The Raleigh Executive Jetport (formerly Sanford Airport) located in Sanford/Lee County is
conveniently located 35 miles from the Research Triangle Park. Located on more than 700
acres off U.S. 1 at exit 76 (Farrell Road), the jetport is about 20 miles from Cary along a fourlane stretch of highway. When the Triangle Parkway phase of I-540 is completed in 2012,
Raleigh Executive Jetport will be 15 miles from the Interstate and Raleigh's outer beltline,
providing even easier access to the capital city, Durham, and the Research Triangle Park.
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Raleigh Executive Jetport serves corporate pilots from the rich manufacturing base in Sanford
as well as Triangle-area pilots wanting an easier, less-crowded alternative to Raleigh-Durham
International. Pilots enjoy a 6,500-by-100-foot runway with parallel taxiway and a weight
capacity of 80,000 pounds. The airport has full lighting, signage and an automatic weather
observation system (AWOS), instrument landing system (ILS), non-directional beacon (NDB),
ground communicator outlet (GCO), and automatic dependent surveillance-broadcast system
(ADS-B). With the ADS-B located on the airport grounds, pilots are able to monitor traffic on the
ground as well as in the air. The airport features full services by FBO Sanford Aircraft Services,
including Jet A and 100LL aircraft fuel, complete aircraft maintenance, avionics repair, pilot
weather services, a flight school, all FAA written tests by computer, secure hangars with limitedaccess gates, courtesy and rental automobiles, and catering. It also has a variety of amenities
for users of the airport.
Community Assets
BRAC
BRAC stands for Base Realignment and Closure, the congressionally authorized process of the
Department of Defense (DoD) to reorganize its base structure to more efficiently and effectively
support our forces, increase operational readiness, and facilitate new ways of doing business.
In 2005, the BRAC Commission’s recommendations were approved by the President and
became law on November 9, 2005. BRAC formed a Regional Task Force which is a partnership
of governments working with the 11 counties (Bladen, Cumberland, Harnett, Hoke, Lee, Moore,
Montgomery, Richmond, Robeson, Sampson, and Scotland) and 73 municipalities surrounding
Fort Bragg and Pope Air Force Base. Their mission is to coordinate the planning and to identify
community impacts as United States Air Force Commands and United States Army Reserve
Commands move to Fort Bragg in 2011.
The BRAC move will impact the Fort Bragg region with availability of thousands of employment
opportunities from construction trades, to civilian employment with the government, to
hospitality. The BRAC Regional Task Force projects the following:
Population growth: projecting 35,000 additional people
Challenges: creates a shortage of schools, classrooms, and teachers and impacts
housing, roads, airports, workforce, infrastructure, public safety, medical and quality of
life
Opportunities: Additional jobs and, with a four-star headquarters, defense-related
companies are moving to our region
16,200 jobs will be created as a result of growth at Fort Bragg
o 4,024 active-duty military jobs; 2,146 military civilian jobs; 1,972 embedded
contractor jobs; 1,000 private defense contractors; plus
o 10,044 jobs will be created in the local economy to support increased population
and military spending
Higher skilled workforce is needed to meet the needs of high tech, defense-related
emerging industries
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Boys and Girls Club of Sanford/Lee County
Boys & Girls Clubs of Sanford/Lee County is a unique organization consisting of two Club
facilities. Their goal is to provide every child with the essential tools needed for a successful
and bright future. Since 1995, the vision of Boys & Girls Clubs has grown and changed with the
needs of the children; as the needs of the children and their families continue to change, so will
the dynamics of the programs and services.
The mission of the Boys & Girls Clubs of Sanford/Lee County is to improve each child's life by
promoting self-esteem, courage, and positive values through all of the educational programs
that are offered. The youth that attend the club receive tutoring, computer training, sports
education, homework assistance, and mentoring. The youth gain confidence by developing a
sense of usefulness and belonging.
Carolina Trace
Carolina Trace is a nationally recognized, award-winning, mastered-planned, gated golf and
country club community developed on 2, 500 acres. Located in Lee County, Carolina Trace
offers an enhanced suburban lifestyle with convenient big city access to art, theatre, shopping,
world-class medical facilities, and universities within 45 minutes of the gated community.
Carolina Trace was developed in 1959 for residents to enjoy an environmentally–focused
community featuring 315-acre Lake Trace, many ponds and creeks, walking trails, rolling hills,
hardwoods, and pine forests within the gated community providing 24-hour security.
Private club members of Carolina Trace Country Club enjoy an active, vibrant social and
recreational lifestyle. Legendary golf course architect Robert Trent Jones, Sr. designed the
Lake Course in 1971 and the Creek Course in 1979. Both championship courses provide a
world-class golf experience.
Depot Park
Depot Park is a true urban park representing the cultural, communal, and economic center of
downtown. The park includes a brick bandstand, a lawn seating area that accommodates
approximately 750 people, brick-banded sidewalks, decorative lighting, ornamental fencing, and
benches. There is an interactive splash fountain with a large landscaped open area
surrounding it, public restrooms designed to conform architecturally to the rest of the park,
continuation of the ornamental fencing, an information kiosk, decorative lighting, a landscaped
parking area, and streetscape along Carthage Street bordering the park. Included in the park is
an historic locomotive popular with children of all ages and the Railroad House, Lee County’s
historical museum.
Today, the park serves as a gathering place for scheduled events such as concerts, patriotic
rallies and leisure activities. Many times during the day people can be found in the park eating
lunch, playing in the fountain, or reading a book.
Golfing
Lee County is home to several beautiful golf courses which attract people from all over the area.
With 43 of NC's finest golf courses within a 15-mile radius, golfers and non-golfers alike come to
the Lee County region for both its fairways and fun. Lee County is a prime location for golfers
from all over the country, not just because of its proximity to prime golf courses in Southern
Pines, Pinehurst, Cary, and other surrounding counties, but because of its own master-crafted
courses. One such course is Tobacco Road located in Sanford which has recently been
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awarded four and a half stars by Golf Digest Magazine and has been named one of
“Americas Top Ten Hardest Courses.”
Lee County Arts and Community Center
Lee County Arts and Community Center (LCACC) is housed in a well-known downtown building
that had its beginnings as Sanford High School. It first opened its doors to students in 1925 and
for many years provided public school education to junior high school and high school students.
In 1975 the school closed and fell into disrepair; however, a few dedicated local residents began
an initiative to restore the building. Ultimately, this 85 year old building became the Lee County
Arts and Community Center which is home to several health and human services agencies and
nonprofit organizations and is available for performing arts groups.
Established in 1996, the LCACC Foundation, through its Board of Directors, oversees the
restoration and upkeep of the Lee County Arts and Community Center, as well as all fundraising
efforts for the center. The Foundation is a nonprofit, tax exempt, 501(c) (3) corporation. Over
the past 24 years, the Lee County Arts and Community Center has played a significant role in
the lives of many citizens in Lee County.
Martin Luther King, Jr. Memorial Park
The Martin Luther King, Jr., Memorial Park was built to honor the slain civil rights leader and
provides a public space for citizens to reflect upon his work and its significance to our country.
The park is located in a beautiful green space at Horner Boulevard and Washington Avenue, the
memorial is visible to the traveling public, as well as to local citizens.
Once the memorial park is completed, it will include a brick memorial wall with Dr. Martin Luther
King’s image, decorative lighting, flag poles, benches and planters. Donors and contributors to
this park can have their names or other text placed on the bricks placed in the walkway leading
up to the column. With a $50.00 tax deductible contribution, a brick will be placed at the
memorial with a personalized inscription.
North Carolina Cooperative Extension
The Ernest and Ruby McSwain Extension Education and Agriculture Center is a governmental
facility designed to accommodate North Carolina Cooperative Extension, Farm Service
Agency, Rural Development Agency, Natural Resources Conservation Service, and the
Lee County Soil and Water Conservation District.
It opened July 10, 2000 and has over 17,000 square feet. North Carolina Cooperative
Extension occupies 7,000 square feet. The USDA agencies located in the facility occupy
over 5,000 square feet. The meeting room has over 4,000 square feet with 1,200
square feet of common areas. These areas may be used for workshops and planning
sessions or for smaller banquets, social gatherings, annual dinners and award
presentations.
North Carolina Veterans Memorial
The North Carolina Veterans Memorial was built to recognize the continuity of sacrifice
between generations and to provide space for names from each succeeding generation
to appear together on the same wall as members of the same brotherhood, as brothers
and sisters of the same family. The memorial demonstrates the heritage of valor, the
honor of sacrifice and the imperative of individual duty. This Memorial Pavilion is located
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in Broadway Park in the town of Broadway, NC. The memorial was built solely from
contributions.
Ole Gilliam Mill
Stephen Henley built the original mill in 1850 and ran it until 1870. In 1870 he sold the mill to
Alexander McIver. Howell, John and Jessie Gilliam leased the mill for many years. In 1890, they
bought the mill and around 500 acres of land from McIver. The Gilliams owned the mill until
1928 when it was washed away by a flood.
The present mill was completed in 1979 up the creek from the original site. It is a faithful
reproduction of the original Gilliam Mill. The reproduction of the Gilliam Mill was constructed by
Worth Pickard on weekends and holidays, with the help of Eddie Paschal, Bill Freeman, Bill
Nielsen, and George Pickard. All working parts were obtained from old mills throughout the
southeast.
The proprietors, Nancy and Worth Pickard, in the year 2000, donated the mill, 15 acres of land,
existing buildings and relics to the Ole Gilliam Mill Park. The park is run by a Board of Directors
and is a nonprofit organization. The park is used for the Ole Mill Crank-Up, church groups,
motorcycle clubs, weddings, family reunions and for people to walk around. The Old Mill CrankUp is a festival honoring the history of Lee County and the spirit of those who relied on the mill
for their way of life more than one hundred years ago.
Parks and Recreation
Lee County Parks and Recreation is dedicated to enhancing the quality of life of all Lee County
citizens and fostering a sense of community. This vision is facilitated by providing a broad
range of recreational and leisure opportunities to the diverse groups within our community. The
activities offered include family parks, walking and bike trails, outdoor education programs,
camps, adult and youth recreational activities, aquatics classes, and sports for all ages. For
more information see Chapter Five, Inventory of Existing Health Resources.
Pottery Festival
The goal of the Sanford Pottery Festival (SPF) is to support the visual arts program in the local
schools, to promote the arts in education creatively, to lead by example, and to encourage
through advocacy so that children all over NC will benefit eventually. This event has received
statewide attention and awards due to the emphasis on art education. The SPF is held each
year during the first weekend before Mother’s Day at the Dennis Wicker Civic Center in Sanford.
Temple Theatre
Temple Theatre was built in 1925 by Mr. Robert Ingram, Sr. (owner of Sanford Coca-Cola
Bottling), at a time when Sanford had a population of only 3,500. Located half a block from the
railroad station, Temple was a frequent stop for the shows and the stars of vaudeville. For
several decades it served as Lee County's principal form of entertainment. After the death of
vaudeville, Temple showed its versatility by becoming a touring house for the road shows of the
1930s (including a bit of burlesque) and later a movie theater. The Sanford Little Theatre and
The Footlight Players used the Temple for its community productions during the 1960s, but in
1965, Temple Theatre closed its doors for fifteen years.
The rebirth of the Temple Theatre began in 1981 when Mr. Robert Ingram, Jr., the son of the
theatre's original owner, donated the building to the citizens of Lee County. Led by Mr. Sam
Bass, the building was designated a National Historic Site in 1983 and given a large challenge
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grant by the NC Legislature. Lee County citizens and businesses matched the grant, along with
a generous grant from the Z. Smith Reynolds Foundation.
Through the efforts of many, the gutted and vandalized shell of Temple Theatre was refurbished
with both the comfort of the theatre patron and the performer in mind. It reopened in 1984.
W.B. (William Bartell) Wicker School
The W.B. Wicker School was built originally as a historically black school and was home to the
first through twelfth grades from 1929 to 1969. In 1969 the school became an integrated
elementary school until the mid 1980’s when it was abandoned. The school was purchased by a
private citizen and was donated to Brick Capitol Community Development Corporation, which
received the North Carolina Small Cities Community Development grant in 2001 to restore the
school.
The restored W. B. Wicker Business Campus is home to the Lee-Harnett-Haven Housing, W.B.
Wicker Business Campus, Small Business Center/Sanford Business Suites, Excel Tutoring and
Personal Development, STOP-N-DROP Academic Center, Central Carolina Community College
Dental Hygiene Programs, and a Community Computer Center.
Young Men’s Christian Association (YMCA)
The Lee County YMCA opened its doors December 2009. The mission of the YMCA is “to put
Christian principles into practice through programs that build a healthy spirit, mind, and body for
all.” The YMCA offers a variety of programs for children, youth, and adults in the areas of
traditional afterschool programs, year-round afterschool programs, day camp, summer camps,
and fitness and wellness classes to meet the needs of the individual.
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CHAPTER TWO
CHANGES
SINCE
2006
COMMUNITY
health
assessment
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2010 Lee County
CHAPTER TWO
Changes Since the Previous Community Health Assessment (2006)
LeeCAN - “A Healthy Carolinians” Update
Over the past four years, LeeCAN (Lee Community Action Network –“A Healthy Carolinians
Partnership”) and the Lee County Public Health Department have worked to address the priority
issues identified in the 2006 Community Health Assessment (CHA). Many changes have
occurred since that assessment. Some of those changes have been positive, and others not so
positive. In the 2006 CHA the most pressing priority health issues centered on the following
three:
Access to Mental Health Care
Obesity in Children and Adults
Teen Pregnancy
Three committees were established under the umbrella of LeeCAN to address each of these
priority health issues. Community partnerships were formed. These partnerships consisted of
community leaders, concerned individuals, profit and nonprofit organizations, businesses, and
faith-based groups.
With the release of the 2006 Community Health Assessment, LeeCAN developed and
implemented a community-wide communication plan, sharing the report with municipal and
county governments, the Board of Education, health and human service agencies, business
leaders, economic development committees, the faith community, the Chamber of Commerce,
civic groups and many others.
Each year as part of the State of the County Health (SOTCH) report, information was shared
with various groups such as the Board of Health, the Board of Education, political officials,
Chamber of Commerce, and many groups and individuals concerning the efforts and results of
the three committees and the state of health overall in the County.
The partnership, the committees’ activities, and overall membership waned due to a variety of
circumstances and lack of continuous direction of a coordinator. In 2009, a new direction and
focus for LeeCAN was launched as part of the Sustainability Plan. A key training, using the
Seven Strategies for Community Change, was conducted by the Healthy Carolinians Director
from a very successful Healthy Carolinians Partnership in another county. Key community
leaders and LeeCAN leadership participated. Current objectives and activities were evaluated
based on the seven strategies, and a new vision and direction for LeeCAN evolved. Throughout
the efforts since the 2006 CHA, the local newspapers, The Sanford Herald and Hometown
News, along with the local radio stations, have been supportive of LeeCAN.
The following information reveals progress has been made on each of the 2006 priorities;
however, there is more work to be done.
Access to Mental Health
The LeeCAN Mental Health Committee was formed to provide Lee County residents with
information about mental health services that are available in Lee County. The committee is
comprised of mental health providers, community agencies, and local concerned citizens. The
overall goal of this committee currently is to “Reduce the Stigma Attached to Mental Health.” It
has not been fully functioning as long as the other two committees.
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Since the 2006 CHA, the committee has accomplished the following:
Developed and distributed a two-sided one-page fact sheet sharing information
describing good mental health and signs that indicate help is needed. The other side
lists providers.
Shared information with county and city law offices’ concerning law officer training on
crisis intervention geared toward understanding mental illness, developmental
disabilities, and substance abuse issues.
Wrote and published a Health Matters column on mental health issues in the local paper.
Increased committee membership with a broad representation of the County including
schools, police, faith groups and concerned citizens.
Shared information at local and state events such as Lee Regional Fair, health fairs, and
state Healthy Carolinians Conference.
Results
Committee membership has increased by over 50%. At least one local law enforcement officer
is on the committee and has been trained in the Crisis Intervention program. One of the major
hurdles continues to be the constant change in mental health policies and procedures. Mental
Illness continues to be a top health priority. A detailed action plan is evolving as we prepare for
the next cycle.
LeeCAN, through the efforts of the committee members (now called Task Force), is being
recognized as a viable and valuable asset in the community.
Obesity
Obesity is a major concern at the county, state, and national level. The current economy and
American lifestyle make it even more difficult to address. To raise the awareness of the issue,
the Obesity Committee focused on two areas: (1) to increase the awareness of Lee County
residents of the obesity problem and to suggest ways to change it; (2) to assist in the
development of programs aimed at educating and informing the community about healthy eating
and moving lifestyles.
To accomplish these goals the committee focused on the following:
Provided information to the public about obesity and solutions:
o A media blitz was launched that included the local TV station, local radio stations,
and the local newspaper
Worked with the schools and community through the NC Eat Smart Move More (ESMM)
programs:
o Eat Smart Move More school and community garden projects
o Move and Groove as part of the ESMM school initiative
o ESMM Faithful Families
o African-American churches ESMM program
o ESMM program offered through the NC Cooperative Extension county office
o ESMM programs offered to local business such as Caterpillar and the City of
Sanford employees
o Offered the ESMM Holiday Challenge
o Conducted the first-ever Lee County Biggest Loser/Healthiest Winner Contest
where the goal was for everyone to become a winner by losing. Fourteen
contestants from all areas and economic levels of the county participated, and
the local newspaper chronicled this and more in the “Healthy Me Healthy You”
weekly section donated to LeeCAN. This included a half or full page spread each
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2010 Lee County
week of the twelve-week program. The challenge incorporated the tenets of
ESMM along with a fitness and counseling component.
Sought designation as a Fit Community partnering with the City of Sanford and
currently are seeking funding through this designation process.
Developed a Walking Trail for the one small town in the county through collaboration
with the town, local churches, and Project Play.
Results
The objective in the 2006 Health Action Plan states a peer county baseline of 17.4% and to
increase the amount of physical activity of overweight and obese children by 15%.
Unfortunately, with the change in leadership and other changes, the baseline has not been
established. Two major obstacles are that no documentation of obesity specific to Lee County
has been formulated, and different ways to measure have been used in reporting information
that is gathered on both the state and county level. Lee County results are included as a part of
a multi-county reporting number.
The results of the final 13 who stayed with the Biggest Loser/Healthiest Winner showed a
composite total of 185 lbs. lost by the participants. Also, they made positive changes in their
physical activity, purchasing, and eating habits. Sustainability is a key part, and follow up will be
conducted to determine if they have maintained their losses.
This committee has just begun their effort. Taking the North Carolina Institute of Medicine
“Prevention for the Health of NC” Prevention Action Plan and the direction of the state Healthy
Carolinians, the LeeCAN Obesity Committee has become the Obesity Prevention Task Force
and is developing action plans based on the divisions of the community-at-large, schools, and
clinical care. One major objective is to assist the school district in gathering and analyzing Body
Mass Index (BMI) on students and also the amount of actual physical fitness activities they are
provided through classroom work and physical fitness teachers.
The Obesity Committee also is keeping abreast of the President’s newly formed Childhood
Obesity Task Force which now has an action plan, the First Lady’s Let’s Move! program and the
National Physical Activity Plan which will be administered at the state level under ESMM.
Teen Pregnancy
The Teen Pregnancy Prevention committee has remained the most stable with the excellent
direction of the Health Department’s Community Health Education and Promotion Section and
the mainstay partnership of the Coalition for Families in Lee County. The Coalition for Families
is a not-for-profit organization made up of county leaders and concerned citizens. Priority areas
for them are the prevention of teen pregnancy and the reduction of infant mortality as well as
parental and family support. Under teen pregnancy the Coalition offers the “Teen Outreach
Program.”
Many activities and initiatives have taken place over the past four years. Unfortunately, the
County continues to rank high in teen pregnancy compared with the state and surrounding
counties. In 2007, the county ranking was 13th in teen pregnancies in the state and this moved
to eight in 2008. The committee realized more had to be done, and it needed more involvement
of the community.
To further address the underlying cause and seek solutions, the Teen Pregnancy Committee
partnered with the Business Department of the local community college and set in motion the
following:
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June 2008 - LeeCAN partnered with Frank Theatres in Lee County and posted teen
pregnancy statistics and prevention information in the lobby of the movie theatre and
as announcements on the screens. These activities reached 67,000 persons from
June through September.
July 2008 - Developed a teen pregnancy brochure which also was translated into
Spanish.
March 2009 -Key Stakeholder Focus Groups- the focus groups discussed teen
pregnancy and identified several factors that may be leading causes of teen
pregnancy.
May 2009 – Teen Pregnancy Community Forum – a host of Lee County’s residents,
business owners, and public officials attended. A panel that included a student
discussed the issues and results of the March focus groups. An audience question
and answer period also was provided.
January 2010 – Lee CAN worked closely with the Family Planning staff of the Lee
County Health Department and created and posted three billboards throughout the
county educating about birth control availability at the health department.
Collaborated with Lee County Schools to distribute flyers about birth control
availability at the high schools.
Posted Birth Control Availability flyers in many of the low-income housing areas and
businesses throughout Lee County.
Continued to seek input of teenagers and also to collaborate with faith-based
organizations in the county. The focus of this effort is to empower students to make
proud choices including (1) Goal Setting and Dream Making, (2) Refusal and
Negotiation Skills, (3) Sexually Transmitted Infections and HIV, and (4) Teen
Pregnancy.
Collaborated with the local school district in the training and implementation of the
new state health education curriculum.
Continued support of the Coalition for Families Teen Pregnancy Programs and the
need for continued funding of these.
Began researching and reviewing what is working to reduce teen pregnancy in other
counties in North Carolina and the nation.
Results
The distressing news is that, while the Coalition’s programs are seeing excellent results, the
county rates have moved Lee County from thirteen highest in the state in teen pregnancy to
ninth and now eighth position in the state. The Coalition can reach only a limited number of
teenagers. Frank conversations, more input from the population involved, and a concerted effort
must be sought.
The remainder of this document will address the 2010 Community Health Assessment, the
results and areas needing to be addressed.
32
2010 Lee County
Chapter three
top Leading
causes of
Death in
Lee County
Le
33
2010 Lee County
CHAPTER THREE
Local, Regional, and State Health Data Comparison
Leading Causes of Death- “What’s Killing Us?”
This chapter is to inform the public about deaths in Lee County, each cause of death is
accompanied with an overview and statistical data showing the actual number of deaths
in Lee County and North Carolina. Additional charts compare the data with peer county
averages. NC-CATCH (North Carolina Comprehensive Assessment for Tracking
Community Health) has grouped Lee County Peer Counties which are: Craven,
Franklin, Harnett and Person County. The peer county is based on the following needs
or risk factors: (1) percentage of population under the age of 18, (2) percentage of
population over 64 years of age, (3) percentage of non-white population, (4) percentage
of families with children (<18) living below the poverty level, and (5) total county
population size.
The following data represents the top ten leading causes of death for Lee County during
2004-2007. The table includes a four-year total number of deaths associated with each
leading cause of death and shows the comparison of the total number of deaths for both
Lee County and North Carolina. The NC CATCH System has not been updated with
2008 mortality and morbidity data, therefore this chapter will only cover the leading
causes of death in Lee County during 2004-2007.
Total Number of Deaths for the Ten Leading Causes of Death
Lee County vs. NC Comparison 2004-2007
Cause of Death
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Rate of Deaths
Lee County
Heart Disease
Cancer
Cerebrovascular Disease (Stroke)
Chronic Lower Respiratory Disease
Diabetes Mellitus
Motor Vehicle Injuries
Alzheimer’s Disease
Nephritic Syndrome
Assault (homicide)
Chronic Liver Disease and Cirrhosis
474
423
116
129
70
70
53
43
29
24
Rate of Deaths
North Carolina
69,914
67,802
18,681
15,995
8,885
6,764
9,306
6,364
3,247
2,541
Technical Note: Rates based on small numbers (fewer than 20 cases) are unstable and should be interpreted with caution.
Source: 2010 County Health Data Book, NC DHHS, Division of Public Health and State Center for Health Statistics
34
2010 Lee County
Heart Disease
Overview
Heart disease is the leading cause of death for both men and women. Life itself is
completely dependent on the efficient operation of the heart. There are many kinds of
heart disease and they can affect the heart in several ways; however, the ultimate
problem with all varieties of heart disease is that, in one way or another, they can disrupt
the vital pumping action of the heart.
Every year about 785,000 Americans have a first heart attack and another 470,000 who
have already had one or more heart attacks have another attack. In 2010, heart disease
will cost the United States $316.4 billion. This total includes the cost of health care
services, medications, and lost productivity. Heart disease is the leading cause of death
for people of most ethnicities in the United States, including African-Americans,
American Indians or Alaska Natives, Hispanics, and Whites (Centers for Disease
Control).
Lee County Data
The graph below shows and compares the rate of deaths caused by heart disease
during 2004-2007 for Lee County, peer county averages, and North Carolina. In 2004,
Lee County had a considerably higher heart disease death rate compared to the peer
counties and NC. Overall, the peer counties’ rates have been consistent throughout the
four year timeframe, while Lee County and NC’s rates have begun to decline since 2005.
Although there has been a decrease in heart disease death rates in Lee County in the
previous years, this chronic illness still remains the leading cause of death for the
residents in the county. Some risk factors of heart disease consist of high blood
pressure and cholesterol, diabetes, obesity/overweight, smoking, and lack of physical
activity. Based on these risk factors, heart disease in Lee County can be prevented by
making the appropriate life style changes.
The local hospital continues to be a leader in the fight against heart disease. The
hospital focuses its care on quality and has been earning national recognitions from
organizations that specialize in benchmarking best practices. The hospital earned the
state’s first gold award for heart failure care from the American Heart Association. This
achievement means that the hospital has consistently performed at or above 85% using
the organizations’ national best practices for disease processes for over 24 months.
There are other resources in the county.
Heart Disease-Age Adjusted Death Rates per 100,000 Population
Source: NC CATCH
35
2010 Lee County
Cancer
Overview
Cancer is a class of diseases in which a group of cells display uncontrolled growth, invasion,
and sometimes metastasis which means spreading to other locations in the body through lymph
or blood. These three properties of cancers are singled out from benign tumors which are selflimited and do not invade or spread. Most cancers form a tumor but some, like leukemia, do
not. The branch of medicine concerned with the study, diagnosis, treatment, and prevention of
cancer is oncology. Cancer affects people at all ages with the risk for most types increasing
with age. Cancer caused about 13% of all human deaths in 2007 (7.6 million) in the United
States (World Health Association).
Cancers are caused by abnormalities in the genetic material of the transformed cells. These
abnormalities may be due to the effects of tobacco smoke, radiation, chemicals, or infection.
Other cancer-promoting genetic abnormalities may randomly occur through errors in DNA
copying or are inherited, thus present in all cells from birth.
Lee County Data
The graph below shows and compares the rate of deaths caused by cancer during 20042007 for Lee County, peer county averages, and North Carolina. In 2004, Lee County
and the peer counties were very close in the number of cancer death rates. In 2005,
Lee County began to see a decrease in the number of cancer death rates with a
dramatic decline in 2007. However, the peer counties remained consistent in 2005 and
2006 but in 2007, there was an increase in the number of cancer death rates. Overall,
NC has remained stable with the rate of yearly deaths caused by cancer for 2004-2007.
Cancer is the second leading cause of death in Lee County. Although, there are many
different types of cancer, prostate and breast cancer are the leading causes of cancer
deaths in Lee County. According to the National Cancer Institute, avoiding the risk
factors that can lead to or cause cancer and increasing the protective factors which can
assist in preventing cancer should be learned and performed by all individuals. Regular
exercise and eating healthy meals and snacks will increase one’s protective factors.
Some risk factors can be avoided such as smoking and drinking alcohol; however,
genetics cannot be altered. These life style changes can lower the risk of being
diagnosed with cancer.
The local hospital offers a variety of diagnostics, surgical and treatment services for the various
cancers (breast, prostate, gynecological, colon as well as other cancers).The surgical staff
(general surgeons, urologists, gynecologists, and gastroenterologists) works with our
oncologist/hematologist to provide an interdisciplinary approach. The hospital continues building
relationships with tertiary care providers to extend services where needed.
36
2010 Lee County
Cancer Age-Adjusted Death Rates per 100,000 Population
250
200
150
100
50
0
Lee Co. Rate
Peer Avg. Rate
NC Rate
2004 2005 2006 2007
Source: NC Catch
Cerebrovascular Disease (Stroke)
Overview
Cerebrovascular disease is a group of brain dysfunctions related to disease of the blood
vessels supplying the brain. A stroke is an interruption of the blood supply to any part of
the brain. A stroke is sometimes called a "brain attack.” During a stroke, blood flow to a
part of the brain is interrupted because a blood vessel in the brain is blocked or bursts.
If blood flow is stopped for longer than a few seconds, the brain cannot get blood and
oxygen (National Stroke Association).
High blood pressure is the number one risk factor for strokes. The following also
increases one’s risk for stroke: diabetes, family history of stroke, heart disease, high
cholesterol, and increasing age. Men have more strokes than women, but women have
a risk of stroke during pregnancy and the weeks immediately after pregnancy. The
following factors can increase the risk of bleeding into the brain, which makes you more
likely to have a stroke: alcohol use, bleeding disorders, cocaine use, and head injury.
The most common stroke signs and symptoms are: (1) sudden numbness or weakness
to the face, arm or leg, (2) sudden confusion or trouble speaking and understanding
others, (3) sudden trouble seeing in one or both eyes, (4) sudden dizziness, trouble
walking or loss of balance and coordination, and (5) sudden severe head ache with no
known cause. Knowing what to look for and reacting quickly could save one’s life.
Lee County Data
The graph below shows and compares the rate of deaths caused by cerebrovascular
disease during 2004-2007 for Lee County, peer county averages, and North Carolina.
The data explains that in 2004, the peer counties had a noticeably higher rate of deaths
caused by cerebrovascular disease but has been showing a decline thereafter. Lee
County’s deaths caused by cerebrovascular disease have fluctuated during the four year
timeframe with a high rate in 2005, a very low rate in 2006 and another slight increase in
2007. Overall, NC has seen a decline in the rate of cerebrovascular disease-related
deaths for 2004-2007.
In 2007, less than 20 percent of NC adults reported that they knew signs and symptoms
of a stroke. North Carolina is part of the nation’s “stroke belt,” an eight to twelve-state
region in the southern part of the country where stroke death rates are much higher than
the rest of the United States. More than one-third of all hospitalized stroke patients in
North Carolina are under the age of 65.
37
2010 Lee County
In 2010, Americans will pay approximately $73.7 billion dollars for stroke-related medical
care and disability (National Stroke Association).
Lee County had a total of 116 stroke-related deaths during 2004-2007, which breaks
down to approximately 29 deaths per year. Up to 80 percent of all strokes are
preventable by making life style changes such as controlling your high blood pressure,
losing weight or maintaining a healthy weight and not smoking. By incorporating these
changes into their lives, Lee County residents could prevent the likelihood of suffering
from a stroke which could lead to an economically burdensome condition.
(National Stroke Association)
The health of the community looks very bright as the local hospital continues to increase
care by earning the American Stroke Association’s silver award for stroke care. The
hospital also employees two neurologists, provides community education on stroke signs
and symptoms, set a protocols in place to help intervene and provide fast care when a
patient is having a stroke and continues to improve efficiencies in the emergency room.
Cerebrovascular Disease (Stroke) Age Adjusted Death Rates per 100,000population
80
60
Lee Co. Rate
40
Peer Avg. Rate
NC Rate
20
0
2004
2005
2006
2007
Source: NC Catch
Chronic Obstructive Lower Respiratory Disease (COPD)
Overview
Chronic lower respiratory diseases refer to chronic (ongoing) diseases that affect the airway and
lungs. The most common disease of the lung is Chronic Pulmonary Disease (COPD) commonly
known as emphysema or chronic bronchitis. COPD is the fourth leading cause of death in the
United States; however, the good news is that COPD is often preventable and treatable.
Emphysema is usually caused by smoking. Having emphysema means some of the air sacs in
the lungs are damaged, making it hard for the body to get the oxygen it needs. Chronic
bronchitis occurs when the cells lining the inside of the lungs’ airways are red and swollen. The
airways in the lungs have become narrow and partly clogged with mucus that cannot be
cleared. COPD develops over time and has no cure. At the onset, there is minimal shortness
of breath, but over time, people with COPD may need oxygen treatment to help with shortness
of breath. Cigarette smoking is the main cause of COPD. People who smoke are 12 times as
likely to die of COPD as opposed to those who have never smoked. Emphysema and chronic
bronchitis also are strongly associated with lung cancer. (American Lung Association)
38
2010 Lee County
According to the National Institutes of Health, approximately 12 million adults in the United
States are diagnosed with COPD, and 120,000 die from it each year while an additional 12
million adults in the United States are undiagnosed.
Lee County Data
The graph below shows and compares the rate of deaths caused by chronic lower
respiratory disease during 2004-2007 for Lee County, peer county averages, and North
Carolina. The data tells that NC overall has had lower and stable rates compared to Lee
County and the peer counties. However, Lee County saw a dramatically higher rate of
chronic lower respiratory disease deaths in 2005 with a decline in 2006 and a moderate
increase in 2007. The peer counties’ rates have remained consistent throughout 20042007.
The NC Chronic Disease and Injury Section reported that for the years of 2003-2007,
NC spent over $400 million in hospitalization charges for COPD. Approximately 38.1
percent of adults in North Carolina who are current smokers reported having COPD.
Although, COPD is a preventable disease, it is still Lee County’s fourth leading cause of
death with the last recordable numbers being on the rise. To prevent COPD, (1) stop or
do not start smoking, (2) avoid second-hand smoke, (3) protect yourself against harmful
chemicals and fumes in the home and workplace, and (4) get as much clean air as
possible.
The resources offered in the county for COPD include the hospital offering a variety of
respiratory diagnostic and treatment services, earning the quality respiratory care recognition
from the American Association of Respiratory Care, May 2009 (approximately 15% of hospitals
in the US received this award), offers education for chronic obstructive pulmonary disease
(COPD), provides pulmonary function test (PFT) screenings at various events in our community
and the hospital is an accredited sleep lab by the American Academy of Sleep Medicine.
Chronic Lower Respiratory Disease (COPD) Age-Adjusted Death Rates per 100,000 Population
Source: NC Catch
Diabetes
Overview
Diabetes is a disease in which the body does not produce or properly use insulin. Insulin
is a hormone produced in the pancreas, an organ near the stomach. Insulin is needed to
turn sugar and other food into energy. When a person has diabetes, the body either
does not make enough insulin or cannot use its own insulin as well as it should, or both.
This causes sugars to build up too high in the blood.
39
2010 Lee County
Diabetes consists of two types, Type 1 and Type 2. Type 1 diabetes usually occurs in
children and young adults. In Type 1, the pancreas makes little or no insulin.
Without daily injections of insulin, people with Type 1 diabetes will not survive. Type 2
diabetes is the most common form. It appears most often in middle-aged adults;
however, adolescents and young adults are developing Type 2 diabetes at an alarming
rate. It develops when the body does not make enough insulin and does not efficiently
use the insulin it makes (American Diabetes Association).
Both forms of diabetes may be inherited in genes. A family history of diabetes can
greatly increase the risk of developing diabetes. Untreated diabetes can lead to many
serious medical problems such as: blindness, kidney disease, nerve disease, limb
amputations, and cardiovascular disease.
Lee County Data
The graph below shows and compares the rate of deaths caused by diabetes during
2004-2007 for Lee County, peer county averages, and North Carolina. The data
indicates that in 2004 and 2005, Lee County had a remarkably higher rate of diabetesrelated deaths but has seen a decline since 2005. The peer counties and NC death
rates related to diabetes have been stable during 2004-2007, but the peer counties’
averages have been higher than that of NC overall and Lee County in 2006 and 2007.
According to the American Diabetes Association, Type 2 diabetes can be prevented by
changing to a healthier diet, increasing your levels of physical activity and losing and or
maintaining a healthy weight. Lee County’s diabetes related death rates are declining
and can continue to decline with self-motivation and community support encouraging a
positive lifestyle change.
Locally the resources in the county include the local hospital which has over 30 primary care
providers and one endocrinologist to treat diabetes. The hospital lab performs A1C tests as well
as other lab work specific to diabetes. Other resources offered by the hospital are community
classes on a variety of diabetic related topics: managing diabetes, diabetes & eye disease,
diabetes & foot health, and diabetic nutrition classes for the general population; special
nutritional classes for gestational diabetes (diabetes during pregnancy); provides free glucose
screenings at a variety of community events; and the Diabetes Bus, a free nonprofit patient
education program (physician referral/order is needed), offers diabetic teaching at CCH on a
regular basis.
40
2010 Lee County
Diabetes Age-Adjusted Death Rates per 100,000 Population
40.0
30.0
Lee Co. Rate
Peer Avg. Rare
NC Rate
20.0
10.0
0.0
2004
2005
2006
2007
Source: NC CATCH
Motor Vehicle Injuries
Overview
In the United States, motor vehicle-related injuries are the leading cause of death for
people ages 1–34, and nearly 5 million people sustain injuries that require an emergency
department visit each year. The economic impact also is notable: motor vehicle crashes
cost around $230 billion in 2000 (Centers for Disease Control and Prevention).
However, motor vehicle-related deaths have been declining over the past 30 years.
North Carolina laws such as mandatory seat belt usage for children, front seat drivers,
and passengers; 0.08 blood alcohol level; and graduated drivers’ licensing have made
North Carolina roads safer for all residents. Highway safety programs have increased
the enforcement of these laws such as "Booze It & Lose It" and "Click It or Ticket It,"
effectively changing the cultural habits for safe driving (NC Department of
Transportation).
Lee County Data
The graph below shows and compares the rate of deaths caused by motor vehicle
accidents (MVA) during 2004-2007 for Lee County, peer county averages, and North
Carolina. Overall, the peer counties and NC have seen a consistent number of MVA
death rates for the four year timeframe. However, Lee County had a considerably higher
rate of MVA deaths in 2004 and 2005 with decreases in 2006 and 2007. During 20042007, Lee County’s MVA death rate was higher than that of NC overall but lower than
the peer county averages in 2006 and 2007.
Based on the North Carolina Department of Transportation’s 2006 Crash Report, in
2004, Lee County had 12 fatal crashes (four alcohol-related), and four nonfatal injuries,
535 crashes (40 alcohol related). In 2005, Lee County reported having 14 fatal crashes
(four alcohol-related) and nonfatal injuries, 481 crashes (30 alcohol-related). In 2006,
Lee County had 17 fatal crashes (seven alcohol-related) and 474 non-fatal injuries crash
related (40 alcohol-related). These numbers show that alcohol usage is a major problem
contributing to Lee County’s deaths by motor vehicle.
41
2010 Lee County
The comprehensive crash cost based on a three year average for all reported crashes
in 2005 dollars showed that Lee County’s motor vehicle accidents had an average
annual cost over $85 million, an annual cost per crash over $45 thousand, an average
cost per person over $1,500 and average cost per vehicle was over $1,600 and the
average cost per 100 miles traveled was $12.59 (North Carolina Department of
Transportation).
These numbers show that alcohol usage is a major problem contributing to Lee County’s
deaths by motor vehicles. This is costing the county millions of dollars annually. To
offset the cost of the motor vehicle accidents in Lee County, our local sheriff’s
department and police department are working closely together to patrol drivers who
may be operating vehicles while under the influence. There has been and will continue
to be an increase in the number of law enforcement vehicles and officers throughout Lee
County insuring road safety for all.
Motor Vehicle Accident Age Adjusted Death Rates per 100,000 Population
50.0
40.0
30.0
20.0
10.0
0.0
Lee Co. Rate
Peer Avg.
Rate
NC Rate
2004 2005 2006 2007
Source: NC CATCH
Alzheimer’s disease
Overview
Alzheimer’s disease is a progressive, degenerative disease of the brain, which causes thinking
and memory to become seriously impaired. It is the most common form of dementia. Dementia
is a condition having a number of symptoms that include loss of memory, judgment, reasoning,
and changes in mood, behavior, and communication abilities. Alzheimer’s disease was first
identified by Dr. Alois Alzheimer in 1906 (Alzheimer’s Association).
Alzheimer's disease eventually affects all parts of a person's life. Since individuals
respond differently, it is difficult to predict the symptoms each person will have, the order
in which they will appear, or the speed of the disease's progression. However, it has
been determined that mental abilities, emotions and moods, behaviors, and physical
abilities are all affected by Alzheimer’s disease.
Lee County Data
The graph below shows and compares the rate of deaths caused by Alzheimer’s disease
during 2004-2007 for Lee County, peer county averages, and North Carolina. The data
indicates that Alzheimer’s disease death rates in Lee County have fluctuated with low
rates in 2004 and 2006 and a considerably higher rate in 2005 and a moderately high
rate in 2007. The peer counties’ average Alzheimer’s disease death rates have been
42
2010 Lee County
lower than Lee County and NC during 2004-2007. NC has seen a consistent death rate
with a slight increase in 2005.
According to the Centers for Disease Control, an estimated five million Americans have
Alzheimer’s disease, which has doubled since 1980. By 2050, it is estimated that 13.4
million persons will be diagnosed with Alzheimer’s disease. According to the National
Institute on Aging, research is being conducted on the possibility of preventing
Alzheimer’s disease or the onset thereof. The key factors contributing to Alzheimer’s
disease include: genetic makeup, environment, life history, and current lifestyle. Some of
these risk factors cannot be controlled but studying an individual’s health, life style and
environment can be a key to preventing Alzheimer’s disease.
Studies have shown that being physically active, having a healthy diet, being socially
active and stimulating the brain, as well as managing pre-existing and chronic diseases
throughout life and during your older years can promote a more promising aging
process. There are limited resources in Lee County for Alzheimer’s disease.
The local hospital provides education through classes, articles on the website and
articles in the hospital magazine.
Alzheimer’s Disease Age-Adjusted Death Rates per 100,000 Population
30.0
25.0
20.0
Lee Co. Rate
15.0
Peer Avg. Rate
10.0
NC Rate
5.0
0.0
2004
2005
2006
2007
Source: NC CATCH
Nephritic Syndrome
Overview
Nephritic syndrome is a group of symptoms including protein in the urine (more than 3.5
grams per day), low blood protein levels, high cholesterol levels, high triglyceride levels,
and swelling. Nephritic syndrome is caused by various disorders that damage the
kidneys, particularly the basement membrane of the glomerulus. This immediately
causes abnormal excretion of protein in the urine (National Institute of Health).
The most common cause in children is minimal change disease. Minimal change
disease is a kidney disorder that can lead to nephritic syndrome. Membranous
glomerulonephritis is the most common cause in adults. Membranous nephropathy is a
kidney disorder which involves changes and inflammation of the structures inside the
kidney that help filter waste and fluids. The inflammation leads to problems with kidney
function (US National Library of Medicine).
43
2010 Lee County
This condition also can occur as a result of infection (such as strep throat, hepatitis, or
mononucleosis), use of certain drugs, cancer, genetic disorders, immune disorders, or
diseases that affect multiple body systems including diabetes. Nephritic syndrome can
affect all age groups. In children, it is most common from age 2 to 6. This disorder
occurs slightly more often in males than females.
Lee County Data
The graph shows and compares the rate of deaths caused by nephritic syndrome during
2004-2007 for Lee County, peer county averages, and North Carolina. The data
indicates that nephritic syndrome death rates in Lee County have fluctuated with an
alarming increase in 2004 but declined thereafter. NC’s overall rate has remained stable
during the four year timeframe. The peer county average rates have seen changes with
a noticeable increase in 2005 and again in 2007.
Studies have been unable to determine a prevention of Nephritic syndrome but there are
some risk factors. The risk factors are: (1) pre-exiting medical conditions that can
damage your kidneys such as diabetes and lupus, (2) non-steroid, anti-inflammatory
drugs and drugs used to fight infections, and (3) certain infections such as HIV, Hepatitis
B and C, and malaria. If you are diagnosed with Nephritic syndrome, the coping process
can be helped by changing your diet to include decreasing the amount of fat and
cholesterol, eating a low-salt diet and increasing the amount of calcium you eat daily
(Mayo Foundation for Medical Education and Research). The local resources include
the local hospital providing dialysis services and a neighboring hospital offering dialysis
on an outpatient basis.
Nephritic Syndrome Age Adjusted Death Rates per 100,000 Population
Source: NC CATCH
Assault (Homicide)
Overview
“Violence is a serious public health problem in the United States. From infants to the elderly, it
affects people in all stages of life. In 2006, more than 18,000 people were victims of homicide,
and more than 33,000 took their own lives” (Centers for Disease Control and Prevention).
Homicides (deaths) and assaults (nonfatal injuries) are injuries purposely inflicted by another
person with intent to kill or injure. In the U.S. in 2002, homicide resulted in the deaths of 18,022
individuals of which 30 percent were young people ages 15-24. Nationally, homicide is the
second leading cause of death for this age group.
For the United States in 2007, 5,764 young people ages 10 to 24 were murdered, an
average of 16 each day. Homicide was the second leading cause of death for young
44
2010 Lee County
people ages 10 to 24 years old. Among 10 to 24 year olds, 86% (4,973) of homicide
victims were male and 14% (791) were female. Among homicide victims ages 10 to 24
years-old, 84% were killed with a firearm. Across the U.S., homicide rates are dropping
among all groups, but the decreases are not as dramatic among youth who already
exhibit the highest rates (Centers for Disease Control and Prevention).
Lee County Data
The graph shows and compares the rate of deaths caused by homicide during 20042007 for Lee County, peer county averages, and North Carolina. For North Carolina, the
overall homicide death rates have remained consistent with a slight increase in 2007.
The peer counties’ average rates saw an increase in 2004 and 2007 with an amazing
decline in 2005 and again in 2006. For Lee County, in 2004 and 2007, the homicide
death rates were similar to that of the peer counties and state. However, in 2005 Lee
County saw a daunting increase in the homicide death rates but welcomed a pleasant
decline in 2006, to be followed by a slight increase in 2007.
Crime in Lee County is something that has been monitored for several years. The
results of this monitoring have brought about several changes for the betterment of the
Lee County citizens. Lee County now has a Gang Prevention Unit, an increase in
organized neighborhood watch programs, more law enforcement officers policing high
risk areas, an increase in the visibility of law enforcement’s mobile units, a concentrated
focus on the elimination of illegal substances, and an overall sense of personal and
property safety for all living and visiting Lee County.
Homicide Age-Adjusted Death Rates per 100,000 Population
Source: NC CATCH
Chronic Liver Disease and Cirrhosis
Overview
Chronic liver disease is marked by the gradual destruction of liver tissue over time.
Cirrhosis is the seventh leading cause of death in the United States, according to the
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Because of
chronic damage to the liver, scar tissue slowly replaces normal functioning liver tissue,
progressively diminishing blood flow through the liver. As the normal liver tissue is lost,
nutrients, hormones, drugs and poisons are not processed effectively by the liver. In
addition, protein production and other substances produced by the liver are inhibited.
The most common cause of cirrhosis is alcohol abuse along with other causes such as
hepatitis, use of certain drugs, chemical exposure, bile duct obstruction, diabetes, and
45
2010 Lee County
many more. Cirrhosis is a progressive liver disease, and damage sustained to the liver
is irreversible. However, with proper nutrition, avoidance of certain toxins (i.e., alcohol),
vitamin supplementation, and management of cirrhosis complications, further liver
damage can often be delayed or stopped.
Lee County Data
The graph shows and compares the rate of deaths caused by chronic liver disease and
cirrhosis during 2004-2007 for Lee County, peer county averages, and North Carolina.
The data explain that chronic liver disease and cirrhosis death rates in Lee County have
wavered with an alarming increase in 2004 and remarkable decreases to follow,
especially in 2006. Overall, the peer counties’ average and NC’s death rates have
remained stable with little to no change during the 2004-2007 timeframe. The local
resources offered by the hospital include four gastroenterologists and one infection
disease specialist on staff.
Chronic Liver Disease and Cirrhosis Age Adjusted Death Rates per 100,000 Population
Source: NC CATCH
Life Expectancy
Lee County Life Expectancy Comparison by Race
RACE
YEAR (1990-1992)
YEAR (2006-2008)
AMT +/-
White
74.8 years
78.5 years
+3.7 years
Black
68.7 years
74.7 years
+ 6 years
Source: NC State Center for Health Statistics: Life Expectancy: State and County 1990-1992 and 2006-2008
AMT: The increase in the number of expected years to live from 1990-1992 to 2006-2008.
46
2010 Lee County
Uninsured Rates
Lee County-Level Estimates of Non-Elderly Uninsured
Area
Children (0-18 years) Adults (19-64 years)
Non-Elderly (0-64
years)
Number
Rank
Percent
Number
Rank
Number
Rank
Percent
Lee County
3,000
High
18.3%
8,000
Mid-Low
11,000
Mid-High
21.2%
North Carolina
345,000 11.3%
Mid-Low
Percent
22.8%
1,232,000 19.5%
Low
1,578,000 19.5%
Low
Source: NC Institute of Medicine
Estimates rounded to nearest 1000 Rank: "High" denotes 25 counties with the highest percent uninsured; "Mid-High" next
25 highest, "Mid-Low" next 25 highest; and "Low" denotes the 25 counties with lowest percent non-elderly uninsured.
47
2010 Lee County
Chapter
four
Community
Health
Assessment
Assessment
Results
48
2010 Lee County
CHAPTER FOUR
Community Health Assessment Results
This chapter of the Community Health Assessment was designed to examine the quality of life
in Lee County by conducting Listening Sessions and distributing Opinion Surveys. In the
Opinion Survey participants were asked how they felt about the health care system, economic
opportunity, safety, and help for individuals in times of need, as well as the quality of life for
children and older adults.
The Opinion Survey was designed to assess perceived community problems and issues.
Participants were asked to pick the top five health problems that have the largest impact on the
community as a whole. Some examples were teen pregnancy, kidney disease, and dental
health. Participants also were asked to choose the top five unhealthy behaviors: some options
included alcohol abuse, drug abuse, and not using seat belts. Participants were asked to pick
the top five community issues that impact the overall quality of life in Lee County; some options
included racism, poverty, and homelessness.
Listening Session participants usually are familiar with one another and already comprise a
group. CHA members were recruited from organizations and agencies. Thirteen of those
volunteers received training as facilitators, moderators, and recorders, and conducted eight
Listening Sessions which targeted a total of ninety people. These approximately one-hour
sessions were held in February, 2010 and centered on several specific, open-ended questions.
In each Listening Session there was one moderator and two recorders.
The following are the ten major areas of concern. Each area has an overview an analysis of the
findings and the disparities.
Aging Problems
Overview
Because Americans are living longer than in previous generations, research is currently
underway with new indicators for better health outcomes for older Americans. The CDC shows
concerns for individuals who are 50 plus years old, and provides initiatives that aim to increase
the use of clinical preventative services among these individuals. For individuals 65 years and
older, the concerns are geared toward management of diseases such as Alzheimer’s disease,
heart disease, and other chronic ailments.
Community Analysis
According to the community health survey, the aging population in Lee County ranked eighth
among problems of greatest concern in the County. When Listening Session participants were
asked to identify the most important challenges facing senior citizens in Lee County, the top
three answers were lack of social support; affordability and/or access to providers; and the
economy, their finances, and unemployment. Some other concerns were lack of transportation,
crime and safety, lack of awareness of services, elder abuse and neglect.
The leading causes of death for senior citizens are heart disease and cancer, both of which
were among the top health problems identified in Lee County. When asked for suggestions to
improve the lives of senior citizens, Listening Session participants most frequently mentioned
increasing volunteer programs that promote senior outreach.
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2010 Lee County
Disparities
The most prominent disparity for older adults involves socioeconomic status and geographic
location. Older adults with lower incomes tend to have less access to quality services, e.g.,
home–health aides, nursing homes, medications, and physicians. Older adults who reside in
rural areas find access to resources even more limited due to inability to travel.
Source: US Census Bureau 2006-2008, Fact Finder
Cancer
Overview
Cancer is the body’s inability to control the growth and spread of abnormal cells. These cells
invade, disrupt, and destroy normal cells and functions of the body. The most prominent
cancers in the United States are lung, bronchus, prostate, female breast, colon, and rectum.
These cancers account for almost 60% of all the cancers in North Carolina.
Community Analysis
According to the Lee County Community Health Assessment survey, cancer was the fifth
among health problems of greatest concern in the county. Early diagnosis and treatment
increase survival rates of individuals with cancer, but often people do not see health care
providers for annual health screenings. Unhealthy behaviors that contribute to developing
cancer were among the top ten unhealthy behaviors overall, e.g., alcohol abuse,
smoking/tobacco use, having unsafe sex, poor eating habits, and lack of exercise.
Disparities
Some of the disparities involved with cancers are race and lack of access to health care due to
socioeconomic status or location. African-Americans die of cancer 35% more often than
Caucasians. Lack of access mainly affects survival rates of cancer; those who cannot afford
screening usually do not get treatment early enough to improve their outcomes. Where
individuals live impacts the accessibility to quality cancer treatment facilities.
Source: NC CATCH
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2010 Lee County
Dental Health
Overview
Oral disease and conditions are among the most preventable chronic health problems in the
United States. The mouth is one indicator for general health and well-being, and there is an
association between oral health problems and overall health problems. Oral health problems
can lead to needless pain, suffering, and complications that can devastate one’s well-being and
have financial and social costs that can diminish quality of life. Tooth decay is one of the most
common childhood diseases. Untreated tooth decay causes pain and infection and may lead to
problems which interfere with eating, speaking, playing, and learning.
Community Analysis
Of the individuals surveyed for the Community Health Assessment, 27.5% stated they needed
dental care in the past 12 months but could not get it. The two most common reasons were lack
of health insurance and unaffordability of care. According to the County Level Oral Health
Status Data of 2008-2009 from the North Carolina Oral Health Section, approximately 21% of
Lee County children entered kindergarten with untreated dental decay compared to 17% in
North Carolina.
Disparities
Disparities for dental health include socioeconomic status, age, and ethnicity. Individuals who
have low income and who live in poverty suffer the most from tooth decay. The disparity is
especially high for children and the elderly. Citizens who do not have insurance or the ability to
pay out of pocket, who have problems with transportation, or who cannot afford to be absent
from work, are most likely to suffer from oral health problems. Disabled individuals and those
with existing complicated health conditions are at greater risk as well. The Hispanic population
has the lowest rate of dental care of any ethnic group. The 2003-2004 North Carolina Statewide
School Oral Health Survey of children showed that disparities by race and ethnicity are
common, and Latino children have higher tooth decay than all other ethnicities.
Source: NC Oral Health Section
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2010 Lee County
Diabetes
Overview
Diabetes occurs when the body is unable to use or produce insulin to regulate body sugar. This
inability causes an imbalance which can lead to medical complications such as eye function,
heart function, kidney function, and blood circulation. Diabetes is the number one cause of loss
of eyesight, kidney failure, and lower limb amputations (not caused by trauma). Some of the
risk factors for diabetes include obesity, lack of exercise, and living in a rural area.
Community Analysis
According to the Community Health Assessment survey, diabetes is the fourth most concerning
health problem. The contributing factors for diabetes were also among high-ranking unhealthy
behaviors such as poor eating habits and lack of exercise. Not going to the doctor for regular
yearly screening also was an unhealthy behavior listed that contributed to some of the long term
effects of diabetes.
Disparities
Some of the disparities that are involved with diabetes and diabetic complications include race,
geographic location, and age. African-Americans are more likely to develop diabetes than
Caucasians. Diabetes is more prominent among individuals over the age of 60 in general, and
20% of African-Americans over the age of 65 have diabetes. Hispanics are more than twice as
likely than Caucasians to suffer from renal failure due to diabetes.
Source: NC State Center for Health Statistics
Heart Disease/Heart Attacks
Overview
Heart disease is the number one cause of death in the United States. Heart disease is a
general term used to describe ailments that involve blood flow disruption or blockage. Some of
the risk factors for heart disease include sedentary life styles, obesity, high blood pressure,
cigarette smoking, high cholesterol, and diabetes. The most common type of heart disease is
coronary artery disease which occurs when cholesterol builds up in the arteries and hardens.
This hardening disrupts blood flow and can eventually block blood flow completely, resulting in a
stroke (brain attack) or heart attack.
Community Analysis
According to the Community Health Assessment survey, heart disease was named the seventh
most concerning health problem in Lee County. Some of the risk factors that contribute to heart
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2010 Lee County
disease were among the top six unhealthy behaviors overall: smoking/tobacco use, poor eating
habits, and lack of exercise. Obesity also was highlighted as the most concerning health
problem in the survey as well as a major health care issue in Listening Sessions. It was the
number one issue facing youth in the Listening Sessions.
Disparities
Some of the disparities involved in heart disease are race, geographic location, and age.
Typically, African-Americans, Hispanics/Latinos, and American Indians suffer from heart
disease and death related to heart disease more often than Caucasians. The southeastern part
of the United States has some of the highest rates of heart disease and strokes in the nation,
and North Carolina has particularly high rates with many of its counties referred to as the buckle
of the stroke belt. Individuals who are 65 years and older are more likely to suffer from heart
disease and death related to heart disease. This is significant to Lee County because the
percentage of senior citizens in the population is higher than the rest of the state.
Source: NC State Center for Health Statistics
Hypertension/High Blood Pressure
Overview
Blood pressure is the force of blood against the walls of blood vessels as it passes through the
body. When blood is having difficulty passing through blood vessels, it causes blood pressure
to rise and remain high. Individuals with high blood pressure are at higher risk for developing
heart disease which can lead to stroke as well as heart attack.
Community Analysis
According to the Community Health Assessment survey, high blood pressure was the sixth
most concerning health problem to Lee County residents. Listening Session participants listed
obesity, poor nutrition, and lack of exercise as contributing factors to high blood pressure and
health care issues in Lee County. High blood pressure also contributes to heart disease and
stroke.
Disparities
Disparities include race, age, sex, and geographic location. African-American and
Hispanic/Latino populations have higher rates of high blood pressure than Caucasians. The
older an individual is the more likely he or she is to develop high blood pressure. For age 55 and
older, women are more often affected than men. People who reside in the southeastern part of
the United States, especially eastern North Carolina, are more likely to be diagnosed with high
blood pressure.
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2010 Lee County
Source: NC State Center for Health Statistics, BRFSS
Mental Health
Overview
There is no universal definition of mental health. The World Health Organization describes
mental health as “a state of well-being in which the individual realizes his or her own abilities,
can cope with the normal stresses of life, can work productively and fruitfully, and is able to
make a contribution to his or her community.” This description of mental health allows for
inclusiveness within the scope of mental health, which includes mental disorders, behavioral
disorders, and substance abuse.
According to the National Institute of Mental Health (NIMH), mental disorders are very common
in the United States. Approximately 26.2 percent of Americans age 18 and older, which
equates to about one in four adults, suffer from a diagnosable mental health disorder in a given
year. “Even through mental health disorders are widespread in the population, the main burden
of mental illness is concentrated in a much smaller proportion, approximately six percent or one
in 17, who suffer from a mental illness. In addition, mental health disorders are the leading
cause of disability in the United States and Canada.” “In the United States, mental disorders
are diagnosed based on the Diagnostic and Statistical Manual of Mental Health Disorders,
fourth edition (DSM-1V).”
Community Analysis
According to the Community Health Assessment Survey, mental health was the third most
concerning health issue to Lee County residents. Substance and alcohol abuse was the sixth
most concerning health care issue for Listening Session participants and the first two
concerning unhealthy behaviors. Twenty-eight percent of the individuals surveyed said that
they had “experienced sadness or worries that kept them from their normal business within the
last 30 days.” Of the individuals surveyed, 8.3% said they did not know where to go or whom to
call if “a friend or family member needed counseling for a mental health or drug/alcohol abuse
problem.”
Disparities
Disparities for mental health include gender, age, and socioeconomic status. Women are more
likely to experience depression, eating disorders, panic, anxiety, and phobic disorders than
men. Eating disorders persist into adulthood and result in the highest rate of death among all
mental disorders. Older individuals are more likely to experience dementia illnesses such as
Alzheimer’s.
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2010 Lee County
Source: NC CATCH
Source: NC CATCH
Obesity/Overweight
Overview
Overweight and obesity are both labels for ranges of weight that are greater than what is
generally considered healthy for a given height. These ranges are determined by the Body
Mass Index (BMI). BMI is a calculation that involves height and weight, and for the majority of
people it correlates with their amount of body fat. Adults who have BMIs over 25 are considered
overweight, while BMIs over 30 are considered obese. The terms also identify ranges of weight
that have been shown to increase the likelihood of certain diseases and other health problems.
(http://www.cdc.gov/obesity/defining.html)
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2010 Lee County
Community Analysis
According to the Community Health Assessment Survey and Listening Sessions, being obese
and being overweight were considered the number one health problem in Lee County. When
Listening Session participants were asked to identify the most important issues facing youth,
obesity and being overweight were tied with poverty as the most frequently given response.
Participants also mentioned the need for nutrition education to improve the lives of children in
Lee County. When asked what community issues residents had concerns about, lack of
recreational activity and availability of healthy food choices were among the top twenty.
Disparities
Common disparities that are involved with obese and overweight populations include racial and
geographical locations. Hispanics/Latinos and African-Americans usually have higher rates of
overweight and obese individuals. Individuals who reside in the southeastern part of the United
States have higher rates of obesity and being overweight. North Carolina has a higher rate than
the rest of the United States, particularly in the eastern part of the state.
Source: NC CATCH
Sexually Transmitted Infections (STI)
Overview
Sexually Transmitted Infections are infections that can be transmitted from person to person
through sexual contact: vaginal, anal, and oral sex. The most common are: chlamydia,
gonorrhea, genital herpes (HSV), syphilis, trichomoniasis (Trich), and Hepatitis B. Of these STI,
chlamydia is the most commonly reported in the United States. Some STI are caused by
bacteria and can be treated and cured; others are caused by a virus and cannot be cured, such
as HIV and herpes. STI pose a tremendous challenge for the public. The Centers for Disease
Control (CDC) estimates there are approximately 19 million new infections every year. Almost
half of them occur in teenagers and young adults from the ages of 15 to 24 years of age.
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2010 Lee County
Community Analysis
According to the Community Health Assessment Survey, STI were the tenth most concerning
health issue to Lee County residents, and having unsafe sex was the third most concerning
unhealthy behavior. When Listening Session participants were asked to identify the most
important issues facing youth in Lee County, sexual health issues were the fourth most
common. When asked to suggest ways to improve the lives of Lee County youth, sexual health
education was among the top five.
Disparities
Health disparities exist in some groups even when behaviors are less risky; other factors such
as poverty, unequal access to healthcare, lack of education, stigma, and racism also contribute
and are linked to health disparities. STI studies show that although the above mentioned STI
are affecting individuals across the board, the minority population are being affected the most
and more specific the minority females. Opportunities to decrease health disparities consist of:
providing education to all by going into the more “high risk” locations; informing the community
overall about available and affordable healthcare services in the area; and working more closely
with healthcare providers on how to relate and understand individuals from different cultures
and backgrounds.
Source: NC CATCH
Teen Pregnancy
Overview
Teen pregnancy or adolescent pregnancy is pregnancy of a young woman under the age of
nineteen. Teenage mothers are more likely to drop out of high school and remain single
parents. Children of teen mothers are more likely to have low birth rates, be born prematurely,
exhibit behavior problems in school, drop out of high school, and become teen parents.
Community Analysis
Teen pregnancy was the second most concerning health problem according to the Community
Health Assessment survey, and the fourth major health care issue in Lee County according to
the Listening Sessions. When participants were asked to identify the most important issue
facing young people in Lee County, teen pregnancy was the third most common response.
Teen pregnancy also was the eighth most frequently mentioned as one of the greatest
challenges facing Lee County.
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2010 Lee County
The third most concerning unhealthy behavior was having unsafe sex. Of the parents surveyed,
sex was the second most frequent issue about which they believed their children needed more
information. When asked what could be done to improve the lives of youth, sexual health
education was the fourth most frequent suggestion mentioned in Listening Sessions.
Disparities
Based on the State Center for Health Statistics 2008 report, Lee County was ranked the eighth
highest county in NC for teen pregnancy. In May 2009 during a Stakeholders’ Meeting, five key
factors were revealed which may be contributing to the teen pregnancy rates in Lee County: (1)
lack of Lack of Sex Education 21%, Low Self-Esteem 16%, Cultural Differences 15%, Lack of
Resources for Youth 15%, and Lack of Parental Support 14%. According to the Healthy Youth
Act House Bill 88, a more comprehensive sexual health education is required to be offered in
the public school system; parents still need to keep the lines of communication open with their
children. Also, while the need for more constructive and adolescent centered programs in Lee
County are few in numbers; this is the time when faith based organizations, nonprofit
organizations, and many others should collaborate together to bring about a better end result for
all the youth in Lee County.
Sources: NC State Center for Health Statistics
Priority Setting
On April 7, 2010 the first priority setting meeting with the Lee CAN Assessment Team took
place with 36 people in attendance. The purpose of the meeting was to begin the process of
prioritizing Lee County’s health issues with future intentions to develop action plans based on
the state’s 2020 health objectives which include the top five priorities listed for Lee County.
The beginning of the meeting was an update and overview of the progress of the Community
Health Assessment. A PowerPoint presentation featured the top ten health problems in Lee
County. For each health problem, the data was analyzed by using the CHA survey data and the
results of the Listening Sessions.
The secondary data demonstrated county/state comparisons of those health problems that were
communicated by the participants. The respondents were given time to ask questions
concerning the data collection and/or the health problem and existing resources. They were
given secret ballots and asked to select the five areas that they determined to be priority issues
over the next four years. The areas selected were: (1) Access to Mental Health Care, (2) Dental
Health, (3) Obesity/overweight, (4) Sexually Transmitted Infections (STI) and (5) Teen
Pregnancy. These priorities carry equal weight since the five areas will be addressed over the
next four years. To follow the format from the state Office of Healthy Carolinians, STI and Teen
Pregnancy will be considered under the same task force. The title of the Obesity Task Force will
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2010 Lee County
change to be more in line with the new state 2020 goals and, because of the close link to
obesity and dental health, this priority will become part of the new Obesity Task Force.
Listed below is the comparison of the 2010 and 2006 health priorities identified by the LeeCAN
Assessment team. The first list contains the top ten health concerns identified by the
respondents in the 2010 survey and Listening Sessions. The second list includes the health
priorities from the 2006 survey and Listening Sessions. Three out of the top priorities identified
in 2006 remained the same.
Top Ten Identified Health Concerns and Community Needs*
2010 Community Health Assessment
1.
2.
3.
4.
5.
6.
7.
8.
9.
Aging problems
Cancer
Dental health
Diabetes
Heart disease/heart attack
Hypertension/high blood pressure
Mental health
Obesity/overweight
Sexually transmitted infections
10. Teen pregnancy
*NOTE: These are in ABC order and not ranking order.
Top Three Identified Health Concerns and Community Needs
2006 Community Health Assessment
1. Access to mental health
2. Obesity/overweight
3. Teen pregnancy
Emerging Issues
Complementary and Alternative Medicine (CAM)
Medical care practices and products that are not considered a part of conventional medicine
include deep breathing exercises, meditation, prayer, deep tissue massage, yoga, Tai chi herbal
medicines, and natural treatments. Complementary medicine is usually used along with
conventional medical practices. Alternative medicine is used in place of conventional medicine.
Integrative medicine combines these treatments with conventional medicine and has shown to
be safe and effective.
CAM treatments are used more prominently by women and individuals with higher levels of
education. A study by the National Center for Conventional and Alternative Medicines showed
that 38% of adults used some type of CAM treatment in the year 2007 and 11.8% of children
used some type of CAM treatment.
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2010 Lee County
Conditions for which adults use these treatments include back pain, neck pain, joint pain,
arthritis, and anxiety. The majority of children used these treatments for conditions including
back/neck pain, head/chest cold, anxiety/stress, ADHD, and insomnia.
Opportunities
There are many reasons why individuals seek the services of complementary and alternative
medicine. The focus of this type of medicine is the well-being of an individual relies on the
entire individual and his or her surroundings. There has been an increase in Lee County of
providers who recognize and facilitate this type of approach to wellness as well as retailers that
supply supplements. Therefore, education and information should be provided about
precautions and benefits of such therapies.
Changing Demographics
Older Adults
The most important demographics to be considered in the coming years are older adults and
senior citizens. These groups have the largest impact on the health-care workforce. In 2002
the average physician spent approximately 30% of patient care hours with senior citizens. In
2020 that is expected to increase by 10%. The rapid increase in the elder demographic will add
pressure to private insurance and Medicare (US Department of Health and human Services,
Health Resources and Services Administration).
Opportunities
The health and well-being of this demographic is imperative to the success of Lee County
because Lee County has a slightly higher number (2% higher) of senior citizens and older adults
than the rest of the state of North Carolina. The leading causes of death for this demographic
include heart disease and cancer. Screenings and prevention strategies should be easily
accessed and facilitated. This particular demographic presents a valuable resource to Lee
County since many of the individuals who will retire in the years to come have developed a
wealth of skills and talents that can be tapped as a powerful volunteer force.
Hispanic Population
This demographic includes any persons of Cuban, Mexican, Puerto Rican, South or Central
American, or other Spanish culture or origin, regardless of race. The Hispanic population of Lee
County has risen from 12% in 2002 to 17% in 2008. The greatest demographic increase in Lee
County Schools has been among the Hispanic population from 11.9% in 2000 to 26.4% in
January 2010. This demographic is expected to continue to grow (Pew Hispanic Center).
Opportunities
The rise in the Hispanic/Latino population presents cultural and linguistic diversity that may
prevent some services from being delivered due to temporarily limited ability to understand and
speak English and inaccessibility to health care services. Culturally appropriate outreach should
be expanded and well established to insure community inclusiveness.
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2010 Lee County
Health Information Technology
‘The mission of the Lee County
Technology has asserted itself in health care.
Government Information Technology
Health information technology allows for medical
Department is to provide our customers
information to be managed and exchanged among
with high quality, cost-effective,
providers rapidly and securely. The use of technology
innovative, and responsive technical
in health care has the potential to improve the delivery
services.”
and quality of health care, prevent human medical errors,
increase efficiency and time spent on patient care, decrease
paperwork, and expand access of affordable care. Technology
also enables easy access to information that has not been available
in the past. It has the potential to be an innovative source and tool for
education.
Lee County is in a unique position when compared to other rural counties. According to the
“Comprehensive Regional Growth Plan for the Fort Bragg Region,” 92% of Lee County
households have availability of access to internet. This is higher than the rest of the state. The
Lee County Health Department has taken advantage of this by providing pages on Facebook
and MySpace to inform individuals of their services.
Opportunities
Emerging technologies present Lee County as well as the City of Sanford with the opportunity to
combine efforts to increase our access and understanding of technology. Increasing access to
free wireless for the public, especially in middle and high schools, as well as the local
community college, would provide lower income students with opportunities to expand their
learning options.
Infectious Disease
H1N1
In 2009 the H1N1 strain of influenza was declared a potential pandemic by the World Health
Organization. This virus, sometimes referred to as the swine flu, is spread from person to
person, much the same way as regular seasonal influenza. The H1N1 virus has been the
predominant influenza virus in circulation so far during the 2009-2010 flu season.
Lee County Health Department worked very diligently to insure that all residents were educated
about the H1N1 virus as well as had access to the vaccine. The vaccine distribution process
involved planning and partnerships that Lee County had not seen in many years.
Opportunities
Anticipation for the H1N1 virus created vaccine clinics and resident educational outreach. These
efforts served to strengthen communication and collaboration among the Health Department,
private practices, and community organizations. The continuation of these relationships creates
an opportunity for quicker responses to any future outbreaks.
Transportation
Transportation within communities traditionally served the purpose of moving individuals and
goods from one place to another. There is growing awareness of how transportation can impact
the well-being of citizens within a community. Assuring that individuals have access to
affordable public transportation is vital to the growth and productivity of a community. The lack
of safe, active transportation options, such as walking and bicycling opportunities, and a lack of
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2010 Lee County
affordable access to public transportation are problematic for Lee County and other
demographically similar communities (CDC, Transportation Recommendations).
Opportunities
Active transportation enhances the quality of life in a society by providing physical activity
opportunities, increasing the sense of community, and lowering motor vehicle emissions. By
supporting sidewalks, cross walks, and bike trails that connect neighborhoods to shopping
areas or schools, Lee County has the opportunity to assert itself as a modern active community.
Lack of public transportation has the greatest effects on poor, elderly, and disabled citizens
because it limits their access to job opportunities, social networks, and health care. Taking into
consideration the current Lee County unemployment rate as well as projected older population,
growth, supporting an infrastructure that promotes safe, affordable public commuting
opportunities is essential to the growth and well-being of Lee County (CDC, Transportation
Recommendations).
Youth Violence and Crime
Youth violence consists of aggressive behaviors performed by youth. These violent acts
include bullying, slapping, verbal abuse, intimidation, rape, assault, and robbery. When these
behaviors begin early, they often continue into young adulthood. Not only the youths performing
the acts are concerning, but also those who are victims as well as witnesses can suffer
emotional harm for many years. This can interfere with school performance and social
interaction, and it can cause isolation and depression. Youth violence has become a cause for
concern all over the United States as well as in Lee County.
Opportunities
Youth violence affects all levels of a community, especially the future of a community. Lee
County Sheriff’s and Sanford Police Department have been proactive in forming gang units to
investigate and prevent gang associated violence. Lee County is presented with the opportunity
to work closely with the school system, to assess the extent of violence present, identify the risk
factors that are involved, develop and execute strategies that prevent and disrupt youth
violence, and work with families and the community to bring awareness to youth violence.
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2010 Lee County
2010 Community Health Opinion Survey Results
We would like for you to participate in a health opinion survey for our county. The purpose of
this survey is to learn more about the health and quality of life in Lee County, North Carolina.
The Lee County Health Department and LeeCAN (Community Action Network) “A Healthy
Carolinian Partnership” will use the results of this survey to help us to develop plans for
addressing the major health and community issues in Lee County. All the information you give
us will be completely confidential and will not be linked to you in any way. The survey is
completely voluntary. It should take no longer than 20 minutes to complete. Thank you for
your participation! Please return your completed survey to your facilitator or mail to:
Lee County Art Center, Lee County Community Health Education & Promotion
507 North Steel Street, Suite 306, Sanford, NC 27330 * A drop box is conveniently located
on the inside of the Lee County Art Center on the 1st floor, please feel free to utilize.
PART 1: Lee County Life
The first questions are about how you see certain parts of Lee County life. Please tell us
whether you “strongly disagree”, “disagree”, “agree” or “strongly agree” with each of
the next 6 statements.
Choose a number for each
statement below.
Statements
Strongly
Disagree
1. How do you feel about this statement, “There is a
good healthcare system in Lee County”? Consider the
cost and quality, number of options, and availability of
healthcare in Lee County.
2. How do you feel about this statement, “Lee County is
a good place to raise children”? Consider the quality and
safety of schools and child care programs, after school
programs, and places to play in this county.
a good place to grow old”? Consider our count’s elderfriendly housing, transportation to medical services,
recreation, and services for the elderly.
4. How do you feel about this statement, “There is plenty
of economic opportunity in Lee County”? Consider the
number and quality of jobs, job training/higher education
opportunities, and availability of affordable housing in Lee
County.
63
5%
Disagree
18.3%
Agree
Strongly
Agree
62.2% 14.4%
3.5% 13.5% 63.1% 20.0%
4.6% 16.1% 61.0% 18.3%
13.0% 53.7% 29.7% 3.7%
2010 Lee County
a safe place to live”? Consider how safe you feel at
home, in the workplace, in schools, at playgrounds, parks,
and shopping centers in Lee County.
6. How do you feel about this statement, “There is plenty
of help for individuals and families during times of need
in Lee County”? Consider social support in Lee County:
neighbors, support groups, faith community outreach,
community organizations, and emergency monetary
assistance.
4.0%
23.3%
63.5% 9.2%
6.5%
27.0% 54.0% 12.4%
PART 2: Community Problems and Issues
Health Problems
7. These next questions are about health problems that have the largest impact on the
community as a whole. Please look at this list of health problems. I would like for you to
pick the most important health problems in Lee County. You can choose up to 5.
Remember this is your opinion and your choices will not be linked to you in any way. If
you do not see a health problem you consider one of the most important, please let me
know and I will add it in. I can also read these out loud as you think about them. (Read
health problems if they prefer to have them read.)
Survey Results
Obesity/overweight
Teenage pregnancy
Mental health
Diabetes
Cancer
High blood pressure
Heart disease/heart attacks
Aging Problems
Dental health
Sexually transmitted disease
Asthma
High cholesterol
Gun-related injuries
10.90%
9.40%
9.10%
8.50%
8.10%
7.40%
7.00%
6.00%
4.10%
3.70%
3.10%
2.70%
2.50%
Infectious/contagious disease
HIV/AIDS
Lung disease
Stroke
Motor vehicle accidents
Infant death
Other injuries
Autism
Kidney disease
Birth defects
Neurological disorders
Liver disease
Osteoporosis
64
2.30%
2.30%
2.20%
2.10%
2.00%
1.30%
1.00%
1.00%
1.00%
0.90%
0.60%
0.50%
0.30%
2010 Lee County
Unhealthy Behaviors
8. These next questions are about unhealthy behaviors that some individuals do that have
the largest impact on the community as a whole. Please look at this list of unhealthy
behaviors. Pick top unhealthy behaviors in Lee County. Please choose up to 5.
Remember this is your opinion and your choices will not be linked to you in any way.
Survey Results
Drug abuse
Alcohol abuse
Having unsafe sex
Smoking/tobacco use
Poor eating habits
Lack of exercise
Reckless/drunk driving
Not going to the doctor for yearly
check-ups and screenings
17.50% Violent behavior
15.60% Not going to a dentist for
preventative check-ups/car
9.60% Not using seat belts
8.80% Not using child safety seats
8.80% Not getting prenatal care
7.20% Not getting immunizations
6.50% Suicide
6.30% Other
6.10%
3.20%
3.20%
2.10%
2.00%
1.20%
1.30%
0.60%
Community Issues
9. These next questions are about community-wide issues that have the largest impact on the
overall quality of life in Lee County. Please look at this list of community issues. Pick the
community issues that have the greatest effect on quality of life in Lee County. Please
choose up to 5. Remember this is your opinion and your choices will not be linked to you
in any way.
Survey Results
Unemployment
Dropping out of school
Affordability of health services
Illegal drugs
Low income/Poverty
Lack of/ inadequate health insurance
9.60%
8.70%
7.70%
7.20%
6.40%
5.80%
Availability of positive teen activities
Lack of transportation options
Inadequate/un-affordability housing
5.60% Availability of healthy family
activities
4.70% Other
4.30% Lack of culturally appropriate
health services
3.90% Lack of health care providers
3.70% Rape/ sexual assault
1.40%
1.30%
Unsafe, un-maintained roads
Violent crime
3.50% Pollution
3.30% Bioterrorism
0.90%
0.10%
Homelessness
Racism
65
Lack of recreational facilities
Availability of child care
Domestic violence
Neglect and Abuse
Availability of healthy food choices
Animal Control issues
3.10%
3.00%
3.00%
2.80%
2.30%
2.20%
2.20%
1.80%
1.50%
2010 Lee County
PART 3: Personal Health
Questions about your personal health. Remember, the answers you give for this
survey will not be linked to you in any way.
10.
How would you rate your own health? Please choose only one of the following:
13.1% Very healthy
7.0% Unhealthy
45.3% Healthy
2.1%
Very unhealthy
32.5% Somewhat healthy
11. Where do you get most of your health-related information? Please choose only one.
56.4% Doctor/nurse/pharmacist
4.0% other _____
11.0% Internet
3.4% Hospital
8.9%
Friends and family
3.1% Church
7.1%
School
0.0% Help lines
6.1%
Books/magazines
12. Where do you go most often when you are sick or need advice about your health?
68.9% Doctor's office
6.8%
Health department
9.0%
Medical Clinic
4.0%
Hospital
7.5%
Urgent Care Center
3.7%
Other
13. In the past 12 months, did you ever have a problem getting the health care you needed from
any type of health care provider or facility?
19.6% Yes
80.4% No (now skip to question #15)
14. Since you said “yes”, which of these problems did you have? You can choose as many of
these as you need to. If there was a problem you had that we do not have here, please write it in
the blank provided.
a. 58.0% I didn’t have health insurance.
b. 8.8% My insurance didn’t cover what I needed.
c. 16.2% My share of the cost (deductible/co-pay) was too high.
d. 4.4% Doctor would not take my insurance or Medicaid.
e. 0.0% Hospital would not take my insurance.
f.
2.9% I didn’t have a way to get there.
g. 0.0% I didn’t know where to go.
66
2010 Lee County
h. 1.5% I couldn’t get an appointment.
i.
7.4% Other: ____________________
15. In the past 12 months, did you have a problem filling a medically necessary prescription?
16.8% Yes
16. Since you said “yes”, which of these problems did you have? You can choose as many of
these as you need to. If there was a problem you had that we do not have here, please tell us
and I will write it in.
a) 56.9%
I didn’t have health insurance.
b) 20.7%
My insurance didn’t cover what I needed.
c) 13.8%
My share of the cost (deductible/co-pay) was too high.
d) 0%
Pharmacy would not take my insurance or Medicaid.
e) 0%
I didn’t have a way to get there.
f)
I didn’t know where to go.
1.7%
g) 6.9%
Other: ____________________
17. Was there a time during the past 12 months when you needed to get dental care, but could
not?
27.5% Yes
18. Since you said “yes”, why could you not get dental care? You can choose as many of
these as you need to. If there was a problem you had that we do not have here, please write it
in.
a. 48.3%
I didn’t have dental insurance.
b. 2.2%
My insurance didn’t cover what I needed.
c. 32.6%
I couldn’t afford the cost.
d. 5.6%
Dentist would not take my insurance or Medicaid
e. 3.4%
My share of the cost (deductible/co-pay) was too
f. 2.2%
I didn’t have a way to get there.
g.
0%
I didn’t know where to go.
h.
0%
I couldn’t get an appointment
i. 5.6%
Other: _______________
67
.
2010 Lee County
19. If a friend or family member needed counseling for a mental health or a drug/alcohol
abuse problem, who would you tell them to call or talk to?
a. 38.8%
Private counselor or therapist
e. 18.3%
b. 20.2%
Support group (e.g., AA. Al-Anon) f. 9.0%
c. 0.6%
School counselor
d. 8.3%
Don’t know
Doctor
Minister/religious official
g. 4.8%
Other
20. In the past 30 days, have there been any days when feeling sad or worried kept you from
going about your normal business?
27.9%
Yes
72.1%
No
21. During a normal week, other than in your regular job, do you engage in any exercise
activity that lasts at least a half an hour?
51.9%
Yes
48.1%
No (now skip to question #24)
22. Since you said “yes”, how many times would you say you engage in this activity during a
normal week?
a. 21.0%
0-2 times a week
b. 36.3%
3-4 times a week
c. 28.0%
5-6 times a week
d. 14.6%
more than 6
times a week
23. Where do you go to exercise or engage in physical activity? Check all that apply.
a. 0.4%
ABC Family YMCA
d. 13.3%
Private gym
b. 23.0%
Park
e. 41.4%
Home
c. 6.1%
Public Recreation Center
f. 13.0%
Other
68
2010 Lee County
24. Since you said “no”, what are the reasons you do not exercise for at least a half hour
during a normal week? You can give as many of these reasons as you need to.
a. 7.30%
My job is physical or hard
labor
g. 11.30%
I don't like to exercise
b. 2.20%
Exercise is not important to
me
h. 21.50%
I'm too tired to exercise
c. 3.60%
I am physically disabled
i. 3.30%
I don't have child care
d. 25.8%
I don't have time to
exercise
j. 3.60%
No safe place to exercise
e. 6.20%
It cost too much to
exercise
k. 2.50%
I don't know how to find
partners or teams
f. 4.70%
I don’t have access to a
facility that has what I need
l. 4.70%
I don't know
m. 3.30%
Other
25. How many hours per day do you watch TV, play video games, or use the computer for
recreation?
32.3% 0-1 hour
26.
41.9% 2-3 hours
8.1% 6+ hours
Do you currently smoke?
16.7% Yes
27.
17.7% 4-5 hours
83.3% No (skip to question 27)
If yes, where would you go for help if you wanted to quit?
a. 1.5%
Quit now NC
b. 36.9%
Doctor
c. 1.5%
Church
d. 1.5%
Pharmacy
e. 12.3%
I don't want to quit
f. 6.2%
Health Department
g. 23.1%
I don't know
h. 1.5%
Private
counselor/therapist
i. 15.4%
Other
69
2010 Lee County
28.
Do you have children between the ages of 9 and 19?
35.8% Yes (now go to question #29)
29.
30.
Do you think your child is engaging in any of the following high risk behaviors?
a. 5.60%
Alcohol use
b. 7%
Tobacco use
c. 5.60%
Eating disorders
d. 64%
I don’t think my child is engaging in any high risk
behavior
e. 9%
Sexual intercourse
f. 4.90%
Drug abuse
g. 3.50%
Reckless driving/speeding
Are you comfortable talking to your child about the risky behaviors we just asked about?
92.4% Yes
31.
7.6% No
Do you think your child or children need more information about the following problems?
a. 14.10%
Alcohol
f. 13.90%
Sexual intercourse
b. 11.70%
Tobacco
g. 11.50%
STD's
c. 12.00%
HIV
h. 13.70%
Drug abuse
d. 3.10%
Other
i. 7.00%
Reckless Driving/speeding
e. 7.70%
Eating disorders
j. 5.10%
Mental health issues
Part 4. Emergency Preparedness
32. Does your household have working smoke and carbon monoxide detectors? (Mark only
one.)
64.0% Yes, smoke detectors only
28.3% Yes, both
.3%
Yes, carbon monoxide detectors
only
7.5%
No
70
2010 Lee County
33.
Does your household have a Family Emergency Plan?
47.8% Yes
52.2% No
34. Does your family have a basic emergency supply kit? If yes, how many days do you have
supplies for?
63.8% No
weeks
11.9% 3 days
11.3% 1 week
5.3% 2 weeks
7.5% More than 2
Part 5. Demographic Questions
The next sets of questions are general questions about you, which will only be reported as a
summary of all answers given by survey participants. Your answers will remain anonymous.
35.
36.
How old are you? (Mark age category.)
2%
15-19
years old
24.1%
45-54 years old
8.3%
20-24
years old
13.6%
55-65 years old
24.7%
25-34
years old
2.2%
65-74 years old
24.4%
35-44
years old
.6%
75 or older
Are you Male or Female?
21% Male
37.
71% Female
Are you of Hispanic origin?
20.9% Yes
38.
79.1% No
What is your race?
2.3%
Asian or Pacific
Islander
.3%
American Indian or
Alaskan Native
25.6%
Black or African
American
55.7%
White
16.2%
Other
71
2010 Lee County
39.
A. Do you speak a language other than English at home? (If no, skip to #40.)
20.6%Yes
79.4%No
B. If yes, what language do you speak at home?
99.6% Spanish
40.
What is your marital status?
25.2% Never married/single
4.3%
Widowed
52.6% Married
6.5%
Separated
2.2%
Other
9.2%
Divorced
41. What is the highest level of school, college or vocational training that you have finished?
Mark only one.
11.5% Some high school, no diploma
13.7% Bachelor’s degree
21.7% High school diploma or GED
14.9% Graduate or professional
degree
16.1% Associate Degree or Vocational
Training
2.8%
Other
19.3% Some college (no degree)
42.
What was your total household income last year, before taxes? I will read out
5 categories. Let me know which you fall into.
19.9%
Less than $14,999
15.8%
$35,000 to $49,000
17.0%
$15,000 to$ 24,999
17.0%
$50,000 to $74,000
12.2%
$25,000 to $34,999
18.0%
Over $75,000
72
2010 Lee County
43.
44.
How many people does this income support?
.7%
0
20.0% 3 people
18.0%
1 person
20.7% 4 people
28.2%
2 people
12.5% 5 or more people
What is your employment status? I will read a list of choices. Let me know which
ones apply to you. Check all that apply.
a.57.%
Employed full-time
f. 1.6%
Student
b. 9.5%
Employed part-time
g.2.5%
Homemaker
c. 2.5%
Retired
h.5.4%
Self-employed
d. 0.6%
Military
i.13.9
Unemployed
e. 6.3%
Disabled
73
2010 Lee County
Listening Session Summary Results
1. Please identify the two most serious barriers to residents accessing
your services?
Summary number of
responses
Lack of communication/ outreach with the Hispanic population: cultural and
language barriers
8
Lack of availability and awareness of services
7
Lack of resources for special needs citizens and disabled citizens
3
Lack of volunteers/community outreach
2
**Answers regarding services were only asked of city and county leaders
2. What are two major health care issues in Lee County?
Summary number of
responses
Obesity and chronic related chronic illness issues
20
Lack of access due to poverty, unemployment or limited income
20
Language barriers are an obstacle to delivering services
4
Teen pregnancy
4
Senior citizen care
2
Drug/alcohol abuse
2
Other
2
3. What are two things that can be done to strengthen the health care
system?
Summary number of
responses
Increase public health awareness
15
School system involvement in health issues/ more education
13
Access to health care services for low income individuals
12
Increase community involvement
6
Improve standards of health delivery from hospitals, clinics, doctor offices,
and EMS
5
Infrastructure changes: sidewalks, pocket parks
4
City and County collaboration and cooperation
2
74
2010 Lee County
Other
4
4. What are the two most important issues affecting the lives of
children/youth in the county?
Summary number of
responses
Peer pressure; gangs; drugs
30
Lack of parental involvement, lack of role models, Drop out
14
Sexual health; teen pregnancy, STI's
12
Obesity, poor nutrition, lack of physical activity
10
Poverty, hunger, abuse
8
Other
4
5. What are two things that can be done to improve the quality of life
for children/youth?
Summary number of
responses
More activities: Afterschool, church, recreational
29
Increase parental involvement/ more mentors
25
More School intervention/ education; school security
10
Increase youth involvement and job availability in the community
6
Sexual health education
5
Nutrition education
5
Others
1
6. What are the two most important issues affecting the lives of senior
citizens in the county?
Summary number of
responses
Lack of family and social support
18
Affordability and access to physicians, dentist, and medication
17
Economy, finances, unemployment
17
Lack of transportation/ transportation options
8
Crime and safety
7
Awareness of available services
4
75
2010 Lee County
Quality of available services
5
Elder abuse/ neglect
2
Other
5
7. What are two things that can be done to improve the quality of life
for senior citizens?
Summary number of
responses
Increase volunteer programs that promote senior outreach
15
Increase senior citizen community involvement
9
Improve access to transportation for seniors
9
Increase number of and improve quality of services: hospital, clinics,
doctors, and dentist
9
Increase awareness of available services for seniors
5
Lower cost for seniors: electric, gas, medication, and other needs
3
Others
2
8. What are the two main threats to safety for the county residents?
summary number of
responses
Crime: drugs, gangs, guns
23
Street lighting, road conditions, pedestrian safety
14
Lack of patrol officers, EMS, first responders
10
Lack of smoke detectors, carbon monoxide safety, and electrical safety
6
School security
4
Lack of enough animal control services
2
Other
3
9. What are two things that can be done to make Lee County safer?
Summary Number of
Responses
Increase law enforcement presence/ improve relationship with the
community
13
Public awareness and education of crimes
9
76
2010 Lee County
More support for law enforcement/ stricter punishment for crime
8
Traffic safety/ pedestrian safety
8
Increase safety during school/ and during afterschool activities
5
More activities and mentors for youth
4
More Jobs and financial resources
2
Other
2
10. What are two major reasons that individuals and families at time
need help because of stress and anxiety?
Summary number of
responses
Financial concerns/ unemployment
15
Illness/ poor health/ health concerns
8
Family stress: divorce/ separation/single parents
8
Drug/ alcohol abuse
6
11. What are two things that can be done to strengthen support for
households that need help with stress and anxiety?
Summary Number of
Responses
Community/ faith based involvement and counseling services
15
Financial education and resources
9
Family strengthening programs
7
Affordable child care and youth programs
4
Drug/ alcohol abuse resources
2
12. What are the two most significant environmental health issues in
the county?
Summary number of
responses
Water pollution
11
Smoking/ air pollution
10
Recycling services/ waste management
9
Other
5
77
2010 Lee County
13. What are two ways the county can improve environmental health?
Summary Number of
Responses
Community involvement/ awareness
8
Convenience and promotion of recycling services
6
Carbon monoxide and smoke detector distribution and education
4
Smoking cessation programs and smoking ban enforcement
4
Other
6
14. What are the two most significant educational needs in the
county?
Summary Number of
Responses
Limited resources/ programs and smaller class sizes
10
Teachers that care
5
Unorganized classes/ ineffective programs
5
More variety in teaching methods
4
More education concerning health issues: obesity and nutrition
3
More diversity among teachers and administration
3
More volunteers and community involvement
3
Dropout prevention
2
Crime and illegal activity prevention in schools
2
15. What are two ways the county can improve education?
Summary Number of
responses
Increase diversity among teaching styles
7
Improve access to supplies and after school programs/ smaller class sizes
6
Life skills/ healthy living education
4
Community/ volunteer involvement
4
More teachers/ diverse teachers/ higher teacher pay
4
Improve teacher/ student/ parent relationships and communication
4
Minority student outreach
2
78
2010 Lee County
16. What are the two greatest criminal justice concerns in the county?
Summary number of
responses
Violence: guns/assault/sexual assault/suicide
12
Drug/ alcohol abuse
9
Burglary and robbery
8
Gangs
7
School safety
3
Other
5
17. What are two ways the county can improve criminal justice?
Summary number of
responses
Community law enforcement partnership/ community watch
8
Increase presence of law enforcement
6
Education and awareness of crime
5
Vigilant school safety and improved school resource officer & student
relationship
3
Other
3
18. Please identify two services or programs that are needed in the
county that are not currently available?
Summary Number of
Responses
Free/ low cost facility for physical activity
7
Youth center/ activities
6
Elderly services
5
Transportation
4
Church/ community programs
4
Counseling Services: drug abuse/ family
3
Hispanic outreach
3
24- hour urgent care center
2
79
2010 Lee County
19. Overall what do you consider to be the county's greatest
strengths?
Summary number of
responses
Community services
7
Convenient Location
7
Small town feel
7
Water planning
5
New business/ beautification
5
People
4
Church involvement
3
Community comes together in times of need
2
New schools/ school renovations
2
Other
4
20. What are the two greatest challenges facing the county?
Summary Number of
Responses
Lack of role models and volunteers for youth
8
Unemployment
6
Economic difficulty/ lack of funding for county services and projects
6
Education
4
Lack of foresight concerning growth
4
Health care delivery
3
Traffic/ pedestrian safety
2
Teen pregnancy/ STI's
2
Other
5
80
2010 Lee County
Chapter Five
COMMUNITY
HEALTH
RESOURCES
81
2010 Lee County
CHAPTER FIVE
Inventory of Existing Health Resources
Access to care continues to be a priority health issue for Lee County residents. Information
provided in this section gives a brief overview of health care professionals currently available in
the county compared with surrounding counties and the comparable (peer) counties of Craven,
Franklin, Harnett, and Person used for Lee County in the North Carolina Comprehensive
Assessment for Tracking Community Health (NC CATCH).
This is followed by a listing of key resources related to CHA priority findings. It is by no means a
comprehensive listing of resources, rather a snapshot of services and resources available. A full
listing can be found in the on-line Lee County 211 system on the Lee County United Way
website.
Comparative Data
Information in the following tables shows how Lee County compares with the state and
surrounding counties as it relates to health care providers. The data is quite comprehensive;
therefore, only specific items were selected that were more in line with the CHA findings. The
third chart shows Lee County 2006-2008 statistics for the same set of professionals in the other
charts. This information was obtained from the Cecil G. Sheps Center for Health Services
Research at UNCCH. For a variety of reasons, the population numbers may not be consistent
with other sources cited in the full document.
2008 North Carolina Health Professionals per 10,000 Population
Lee and Surrounding Counties
Health
Professionals
Physicians
Primary Care
Providers
Dentists
Dental Hygienists
Pharmacists
Registered
Nurses
Physician
Assistants
Licensed
Practical Nurse
Psychologists
Psychological
Associates
Lee
State
Chatham
Moore*
Harnett
15.5
8.3
21.2
9.0
6.9
5.4
31.3
10.3
5.6
3.8
3.5
6.3
6.6
62.6
4.3
5.4
9.3
95.1
2.3
4.6
6.7
40.1
6.6
6.0
9.0
136.0
1.7
4.8
6.5
35.4
3.8
3.5
.07
5.3
2.1
24.0
19.4
18.1
33.9
14.9
0.3
0.0
2.0
1
1.3
0.7
0.5
0.8
0.3
0.8
Source: www.shepscenter.unc.edu
NOTE:*Moore County has a Regional Hospital and many specialty area doctors and
services around the hospital and the county.
Populations: State 9,227,016; Lee 57,511; Chatham 60,895; Moore 85,293; Harnett 109,659
In comparing the numbers of overall primary health providers in neighboring counties to Lee
County, Lee County is below the state in most of these areas; however, it is above neighboring
counties when examining the combined totals for physicians, primary-care providers, registered
nurses, physician assistants, and licensed practical nurses. This appears to be a strength in Lee
County. The exception in this comparison is Moore County where there is a major health
complex and a vast number of more primary providers, such as doctors and registered nurses.
82
2010 Lee County
Lee County has a much higher rate for dental care professionals than Chatham and Moore
Counties and is even higher than the state when dentists and dental hygienists are combined.
Yet, this is a top priority health issue as stated in the local CHA results. More on this is
discussed in Chapter 3 of this document.
The 2008 statistics show that Lee County has a lower rate of mental health professionals than
the state and all surrounding counties with .3 per 10,000 while the state and other counties are
at least one professional or higher per 10,000. This is definitely a weak area. Access to Mental
Health was listed as one of the top five health issues for the people in Lee County.
2008 North Carolina Health Professionals per 10,000 Population
NC CATCH Comparable Counties
Health
Professionals
Lee
State
Craven*
Franklin
Harnett
Person
Physicians
15.5
21.2
21.4
5.4
5.6
9.6
Primary Care
Providers
8.3
9.0
7.8
3.3
3.8
5.1
Dentists
3.5
4.3
4.4
1.0
1.7
2.1
Dental Hygienists
6.3
5.4
5.0
5.8
4.8
3.5
Pharmacists
6.6
9.3
8.0
3.6
6.5
6.1
Registered
Nurses
62.6
95.1
103.6
36.3
35.4
50.1
Licensed
Practical Nurses
24.0
19.4
24.0
12.6
14.9
10.9
Physician
Assistants
3.8
3.5
3.3
0.7
2.1
2.9
Psychologists
0.3
2.0
1.3
0.2
0.3
0
Psychological
Associates
0.0
1.0
1.9
0.0
0.8
0.3
Source: www.shepcenter.unc.edu
*Major hospital complex
In comparing Lee County with NC CATCH peer counties, Lee County, with 114.2 per 10,000,
has a higher number of health providers than the other counties with the exception of Craven
where a major health care regional center is located.
Dental health provider statistics show Lee County above the state and comparable counties.
When looking at dentists only, Lee County drops below the state and Craven County while
remaining higher than the three other comparable counties.
Mental health provider statistics show Lee County to be third lowest of the five counties, tied
with Person County, for providing these services by a professional. This, as stated earlier, is a
major issue and concern of the citizens of Lee County.
83
2010 Lee County
2006-2008 North Carolina Health Professionals per 10,000 Population for Lee County
Health
Professionals
2005
2006
2007
2008
Physicians
14.9
15.4
15.1
15.5
Primary Care
Providers
8.3
8.3
8.5
8.3
Dentists
4.2
3.6
3.2
3.5
Dental Hygienists
N/A
6.7
6.6
6.3
Registered Nurses
72.5.
64.6
64.2
62.6
Licensed Practical
Nurses
N/A
25.0
24.7
24.0
Physician
Assistants
2.57
3.4
3.9
3.8
Psychologists
N/A
0.7
0.5
0.3
Psychological
Associates
N/A
0.4
0.2
0
50,493
55,282
56,376
57,511
Population
Source: www.shepcenter.unc.edu
Of major importance when reviewing this information is that Lee County has continued to grow
over the past four years, but since 2006 the number of health professionals has not seen much
growth. The number of dentists, registered nurses, and physician assistants has actually
declined. This is definitely a weak area that requires attention as the county’s population is
expected to increase with the proximity to areas such as Raleigh and Fayetteville with its influx
related to Fort Bragg’s expansion.
The comprehensive report for the Fort Bragg Regional Growth Plan, mentioned in Chapter One,
confirms this information. It draws the conclusion that based on future anticipated growth. Lee
County’s most pressing future physician needs are for medical and surgical specialists.
Health-Related Resources
211- Get Connected. Get Answers.
www.nc211.org; www.leecountyunitedway.org
Lee County offers the state 211 Get Connected. Get Answers assistance system. This is
currently the most comprehensive listing of services available to county residents. If Lee
County residents need services for food, housing, employment, health care, child care,
volunteer opportunities, crisis intervention, and/or legal assistance, this is the main source for
assistance via a 211 call, the 211 website, or United Way of Lee County. All information is free,
confidential, and available 24 hours a day. Lee County 211 is staffed with agents who speak
several languages.
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Primary Health Assistance
Lee County Public Health
Contact: Howard Surface, Health Director
Phone: (919) 718-4640
Email: [email protected]
Located: 106 Hillcrest Drive
Sanford, NC 27330
Mailing address: P.O. Box 1528
Sanford, NC 27331
Fax: (919) 718-4632
Website: www.leecountync.gov
Clinical Services
Service description: Pregnancy tests, prenatal care, WIC Certification (Food Vouchers),
Screening and Treatment for STIs, Pap Smears and Family Planning, Immunizations, TB followup, Child Health, Child Service Coordination, Maternity Care Coordination, and Health
Education Classes.
Hours: Monday-Thursday 8:00 a.m.-5:00 p.m., Friday 8:00 a.m.-11:30 a.m.
Intake: Call for an appointment. Walk-ins accepted.
Languages: English and Spanish
Lee Primary Care
Service description: Physical exams, vaccinations, lab testing, acute care, high blood pressure
and diabetes care, affordable routine health-care for the uninsured, lab and EKG services,
assistance with medications for those who qualify.
Eligibility: Services for Lee County residents; no insurance accepted.
Fees: $45 for office visit and additional lab fees may apply
Hours: Monday, Tuesday, Wednesday and Friday 8:00 a.m.-4:00 p.m.
Thursday 8 a.m.-12 p.m.
Intake: Call for an appointment. Walk-ins are welcomed.
Community Health Education & Promotion
Service description: Community Health Assessment/Evaluation, Community Health Fairs,
Educational Resource Department, Educational Training, Adolescent/Sexual Issues, Nutrition
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and Physical Activity, Tobacco Prevention, Grant Writing, and Policy/Environmental change.
Trainings and materials available upon request
Hours: Monday-Friday 8:00 a.m.-5:00 p.m.
Directions: Arts and Community Building (former School Building), Corner of Weatherspoon
and Steele Street.
Fees: Free
Environmental Health
Service description: Inspections and permits for septic tank/well systems; inspections and
permits for food, lodging, and institutional establishments, public swimming pools and tattoo
parlors; lead investigations for children. Please call.
Directions: 900 Woodland Ave. Corner of Makepeace and Woodland Avenue.
Lee County Animal Services/Shelters
Service description: Investigates nuisance or dangerous animals, animal bites, and animal
cruelty, captures and impounds stray or unwanted animals, rabies investigation, enforcement of
Lee County and City of Sanford ordinances and North Carolina laws concerning animal control,
public education and media contracts on animal control issues, pet adoptions.
Hours: Monday-Friday 8:00 a.m.-5:00 p.m., Saturday 8:00 a.m.-12:00 p.m.
Languages: English and Spanish
Central Carolina Hospital (CCH)
Contact: Doug Doris, CEO
Phone: (919) 774-2100 (Main hospital)
1-800-483-6385 (Physician referral)
Address: 1135 Carthage Street
Sanford, NC 27330
Website: www.centralcarolinahosp.com
Directions: At the corner of Carthage Street and Fields Drive.
Service description: Acute care hospital providing emergency medicine, diagnostic imaging,
physical rehabilitation and cardiopulmonary services. There is a 128 acute-care bed capacity
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with nine psychiatric beds.
Hours: Emergency room open 24 hours per day
Fees: Accepts Medicare, Medicaid, private insurance, self-pay. Uninsured patients, call (919)
774-2100 to speak with a case manager.
Languages: English, Spanish
Helping Hand Clinic
Contact: Marilyn Green, Director
Phone: (919) 776-4359
Address: 507 North Steele Street
Sanford, NC 27330
Directions: In the basement of the Lee County Arts and Community Center (old high school) on
the corner of Horner Boulevard and Weatherspoon St.
Chronic Care Clinic
Service description: Offers medical care and prescription medications to uninsured chronically
ill people who are living below the poverty line.
Fees: No charge, donations accepted
Dental Program
Service description: Free dental care to those in need that are low-income and without
insurance.
Eligibility: Uninsured, low-income
Eye Care Program
Service description: Free eye care, exams, and prescription eyewear.
Fees: No charge, donations accepted
Walk-In Pharmacy
Service description: Fill prescriptions at on-site pharmacy, free of charge, to persons without
insurance and who are low-income.
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Mental Health
Sandhills Center for Mental Health
Contact: Bill Larrison, Lee County Access Unit Manager
Phone: 1-800-256-2452 Toll Free 365 days per year – 24 hrs. a day
Address: Administrative Offices
1120 Seven Lakes Drive
West End, NC 27376
Website: www.sandhillscenter.org
Service Description: It is a Local Management Entity of the NC Department of Health and
Human Services. Under State Policy Sandhills Center conducts annual and on-going needs
assessments and contracts for the delivery of services by private providers. They manage the
providers for eight counties.
Sandhills Center Local Management Entity
Contact: Linda Swann, M Ed., NSMI NC Sandhills Programs Coordinator Lee Harnett Family
Support Program
Phone: (910) 985-0126 Toll Free 1-877-776-6702
Contracted through: the Mental Health Association in NC and National Alliance on Mental
Illness (NAMI)
Description: Provide support to families of children with emotional, learning, or behavior
challenges.
The family support programs empower and educate families and professionals to access the
knowledge, training, and treatment options available within the community in order to receive
appropriate services. They provide advocacy and support groups and a wide variety of
workshops. Some examples of the workshops are: Child and Family Teams, Anger
Management, Effective Parenting Skills, Medication and Children, Gang Awareness, Healthy
Minds! Healthy Kids!
There are also several private providers in the county. Many of those currently serve on
LeeCAN “A Healthy Carolinian Partnership” Access to Mental Health Task Force
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Aging Services
The Enrichment Center of Lee County
Lee County Senior Services
Contact: Deborah Davidson, Director
Phone: (919) 776-0501
Address: 1615 S. Third Street
Sanford, NC 27330
Fax: (919) 774-7593
Directions: On S. Third Street between Horner Boulevard and Courtland Avenue, near Ham's
restaurant
Description:
Lee County Senior Services offers comprehensive services and programs for the county’s
senior residents. The 211 directory describes each of these offerings in detail. Please refer to
the directory for a full description of each.
Programs
Service description: The Enrichment Center of Lee County is a North Carolina Senior Center
of Excellence. It is a focal point in the community where patrons access services and engage in
activities. The Center collaborates with area health care professionals to offer health fairs;
health education self-care seminars; healthy eating cooking classes; and disease prevention.
The Enrichment Center offers a variety of educational programming, entertainment, fitness and
health and wellness opportunities. The Center offers various classes from topics concerning
financial planning, insurance, drivers’ refresher courses, art classes, current events, cooking
classes, dancing, fitness, crafts, and computers. Evening dinner and entertainment scheduled at
various times throughout the year. Thursday and Saturday evening dances at 7:00 p.m.
Advanced Directives: Health Care Power of Attorney & Living Will
Service description: Forms, witnesses, and notary: these services are provided free of charge.
Congregate and Home-Delivered Meals
Service description:
Congregate Nutrition-A nutritious lunchtime meal is provided Monday-Friday at noon to Lee
County residents age 60 and older by Lee County Senior Services. Health education, social,
recreation, and access to other services also are available.
Home Delivered Meals-A hot nutritious lunch is delivered by volunteers five days a week to Lee
County residents who are 60 and older and homebound.
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Eligibility: Lee County residents, age 60 or older
County Veterans Service Office
Service description: Advocacy assistance for veterans and their families seeking benefits from
the Veterans Association.
The Ensure Program
Service description: The Ensure program is an indigent program established with Ross
Laboratories. The program assists clients that are in need of a nutritional supplement to sustain
life by allowing the product to be sold at a lower rate than in retail stores.
Family Caregiver Program
Service description: The Family Caregiver Program provides information and referral services,
assesses needs, helps the caregivers to find solutions available in our community, offers
educational services such as caregivers training, conferences, seminars, support groups, and
provides respite care, allowing caregivers time to meet other responsibilities.
Fitness (EC Fitness)
Service description: Fitness classes at the Enrichment Center include yoga, low-impact
aerobics/strength, water aerobics, and a chair stretch and tone.
Fitness Room (EC Fitness Room)
Service description: Fitness room is equipped with treadmills, dual action bikes, recumbent
cycles, stair climber, rowing machine, health rider, small hand weights, weight station, and
more.
Helping Fund
Service description: Helping Fund Policies: The Helping Fund is an emergency financial
resource for indigent older adults. Assistance will be considered for the following services:
electrical bills, necessary prescriptions, water bills, fuel bills (LP, natural, propane, and
kerosene), wood for heating, partial rent in extreme situations (homeless), if needed for medical
reasons only--basic telephone, food in emergency situations.
Housing Home Repair
Service description: An assistance program which operates on limited state funds and is used
primarily to build wheelchair ramps on a first come, first serve basis to eligible Lee County
homeowners who are age 60 or older.
Information and Assistance
Service description: Information and Assistance (I&A) provides information on services related
to older adults and their families and assistance to older adults having difficulty navigating the
numerous services available to them.
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Respite Referral
Service description: The Respite Referral program was developed to help caregivers find
home-care workers to assist them in caring for individuals in the home.
Senior Games and Silver Arts of Lee County
Service description: Senior Games and Silver Arts of Lee County is a year-round health
promotion program. Senior Games and Silver Arts of Lee County is part of a network of 53
Local Games sanctioned by North Carolina Senior Games, Inc. and is open to all Lee County
residents 55 years of age and better. Events are held each spring and are qualifying events for
North Carolina Senior Games State Finals are held each fall in Raleigh and surrounding areas.
Senior Trips
Service description: To plan and conduct fun and entertaining day and overnight trips that are
affordable to everyone.
Seniors Health Insurance Information Program (SHIIP)
Service description: Seniors Health Insurance Information Program (SHIIP) is a consumer
information division of the North Carolina Department of Insurance that assists people with
Medicare, Medicare Part D, Medicare supplements, Medicare Advantage, and long-term-care
insurance questions. SHIIP also helps people recognize and prevent Medicare billing errors and
possible fraud and abuse through our NCSMP Program.
Support Groups
Service description: Diabetes Support Group: This group is for the diabetic as well as
caregivers and loved ones of diabetics.
Living with Vision Loss Support Group: This group was created for people with vision
impairments (including Macular Degeneration) and their loved ones to discuss ways to cope
with low vision.
Grancare Support Group. This group is for grandparents who are raising or assisting in raising
their grandchildren.
Prostate Support Group. The group concentrates on the sharing of experiences that stimulate
psychological, social, and emotional awareness to enhance quality of life. An educational
component provides information on nutrition, sexuality, coping skills, and diagnosis and
treatment modalities. An emphasis is placed upon outreach to men with newly diagnosed
cancer of the prostate.
Alzheimer's Support Group: Caregivers of loved ones with Alzheimer's come together and
support each other through sharing of their knowledge, experiences, and advice.
Caregivers Connections Support Group: This is an opportunity to share your concerns,
problems, and ideas in connection with caring for your loved one as well as learning from the
knowledge of others who may be experiencing a similar situation.
Parkinson's Disease Support Group: Support, problem solving, and education for persons with
Parkinson's disease, families, and caregivers.
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Sanford Cancer Support Group: Commitment to provide information and support to anyone who
has been touched by cancer.
Arthritis Support Group: An educational and mutual support group that will focus on helping
people with any form of arthritis.
Parents Support Group-Living with Loss of a Child: Commitment to provide support to anyone
dealing with the loss of a child.
Grief Support Group: Provides an opportunity for those persons who are grieving to come
together for support and assistance with the grieving process.
Volunteer Opportunities
Service description: To screen and place interested persons in volunteer positions in the
community.
County of Lee Transit System (COLTS)
Service description: COLTS is a coordinated transit system that provides transportation
services for the general public and human service agencies in Lee County. Provides
transportation for citizens of Lee County to work, medical appointments, shopping, Senior
Services, and necessary errands. Medical transportation is available to Chapel Hill and Durham
(Tuesday-Thursday) COLTS has lift vans available for physically challenged persons who are in
wheelchairs or have mobility concerns. Fees: No cost for seniors over 60 for medical
appointments. Website: www.leecountync.gov
Meals on Wheels of Sanford
Website: www.mowsanford.org
Service description: Delivers one meal per day, Monday through Friday, to homebound
persons unable to cook or shop for themselves.
Eligibility: Anyone who lives within Sanford city limits who is homebound and unable to shop or
cook for themselves.
Hours: Answering service seven days a week; response is normally same day.
On the Road Again
Service description: Volunteer program provides free rides to residents of Lee County for
medically- related rides within the County and to Moncure Clinic. Car seats are not provided;
you must bring and use your own.
Directions: St. Stephen Roman Catholic Church on corner of Franklin Street and Carbonton
Road.
Hours: Seven days a week, 8:00 a.m.-5:00 p.m.
Intake: Call by noon two days before ride is needed.
Languages: English and Spanish.
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Highway to Healing
Directions: Mail received and meetings held at Lee County Enrichment Center
Service Description: Highway to Healing is a free transportation service for Lee County cancer
patients.
Eligibility: Must need cancer treatment and live in Lee County.
Intake: Telephone call to center
Dental Health
Central Carolina Community College
Dental School
Contact: Dental School Instructor
Phone: (919) 775-2122
Address: 900 South Vance St., suite 220
Sanford, NC 27330
Directions: Top of the hill off of Wicker St. on the right on Vance St. (former Wicker School)
Service Description: This program is part of the continuing educational offerings through the
local community college. It is a training program. Dental hygienist students, under the
supervision of an instructor, offer basic services to the community such as dental cleaning,
quadrant scaling, fluoride treatment, X-rays, and sealants. Currently services are free.
Public Health Dental Hygienist Serving Chatham and Lee Counties
Contact: Wendy Seymore, RDH
Public Health Dental Hygienist
Department of Health and Human Services
NC Oral Health Section
Serving Chatham and Lee Counties
Phone: (919) 777- 0225 ext. 202
Address: 507 N Steele Street, suite 306
Sanford, NC 27330
Service Description:
The public health dental hygienist provides services in four main program areas: Dental
assessments, along with follow up and referral, are provided for all K-5 students in Lee
County. Data are collected on kindergarten and fifth-grade students through a calibrated
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dental assessment, which looks at decayed, filled and missing teeth, additionally looking
at sealant usage in fifth-grade students. These data are collected statewide as well as in
Lee County. Data are collected to identify high risk schools in order to target preventive
dental programs that are provided by the State of North Carolina through the North
Carolina Oral Health Section.
Dental health education is provided to any group upon request. The bulk of time is spent
in Lee County elementary schools.
Dental sealants are provided annually through "Give Kids a Smile.” This event includes
screening, education, and sealant placement. The public health dental hygienist
coordinates this event each year. This is a collaboration that involves Lee County
Schools, Lee County Dental Society, and local volunteer dentists, hygienist, and dental
assistants as well as the dental programs at Central Carolina Community College and
the North Carolina Cooperative Extension.
Fluoride mouthrinse is provided to four Lee County schools. This is a weekly
topical fluoride mouthrinse provided to all first through fifth-grade students whose
parents give permission. The public health dental hygienist coordinates this with the
help of a school fluoride mouth rinse coordinator in each of the four schools. As funds
become available through the North Carolina State Legislature, it is hoped that this
program will be expanded to include all Lee County elementary schools.
Obesity/Health Related
Lee County Cooperative Extension
Contact: Susan C. Condlin, County Extension Director
Phone: (919) 775-5624
Address: 2420 Tramway Road
Sanford, NC 27330
Fax: (919) 775-1302
Website: http://lee.ces.ncsu.edu
Service description: Family and Consumer Science, Horticulture, Agriculture, 4-H, Farmer’s
Market.
Lee County 4-H
Service description: The 4-H program is open to all young people in Lee County between the
ages of 5 and 18. Through 4-H, youth can participate in a variety of programs including: 4-H
Clubs, presentations, record books, school enrichment, community service, 4-H Congress,
leadership events, 4-H Camp and summer fun. The main purpose of the 4-H program is to
develop life skills that will help the youth be successful and productive members in their
communities.
Eligibility: All youth ages 5-18.
Fees: No fee to join 4-H; minimal cost for some programs.
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Sanford Farmers’ Market
Service description: Farmers’ Market featuring locally grown produce. Farmers live and grow
their produce within a seventy-five mile radius of Sanford. Seasonal fruits, vegetables, meats,
eggs, crafts and a variety of other products sold.
Directions: Located at Depot Park in downtown Sanford between Charlotte, Moore and
Chatham streets at the railroad tracks.
Hours: Saturday 9:00 a.m.-12:00 p.m. beginning April 26. Market will be open in July on
Tuesdays from 10:00 a.m.-12:00 p.m. at the Lee County Enrichment Center. Market will close in
October.
Lee County Parks and Recreation
Contact: John Payne, Director
Phone: (919) 775-2107
Address: 2303 Tramway Road
Sanford, NC
Fax: (919) 775-1531
Service description: Offers youth and adult recreation programs. Programs available are:
baseball, softball, basketball, tee-ball, pee-wee baseball, volleyball, football, yoga, gymnastics,
children's dance, tiny tots, summer camps, swim lessons, and other special events throughout
the year. Call office for more information.
There are several weight-reduction options such as the hospital programs, LeeCAN Biggest
Loser/Healthiest Winner program, Eat Smart Move More programs, Overeaters Anonymous,
Weight Watchers, and TOPS.
Teen Pregnancy
Coalition for Families of Lee County
Contact: Carolyn Spivey, Executive Director
Phone: (919) 774-8144
Located: 507 N. Steele Street
Sanford, NC 27330
Sanford, NC 27331
Fax: (919) 774-0631
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Directions: At the northern end of Steele Street in the Lee County Arts and Community Center
Building on the 2nd floor.
Hours: Monday-Friday, 8:30 a.m.-5:00 p.m.
Child Care Resource and Referral (CCR&R)
Service description: A multi-dimensional program designed for parents and child-care
providers. CCR&R provides information to parents that will help them choose affordable, quality
care. They will provide unbiased referrals to all licensed child-care facilities. CCR&R also serves
as a resource for all child-care providers to have access to knowledge and materials that will
create a learning environment within their facilities. Training for all child-care providers is offered
and credit hours are issued. A "Resource Library" is available for membership to all child-care
providers and parents for a small fee.
Languages: English and Spanish.
Fees: None except for a small library membership fee.
Parents as Teachers
Service description: A home visitation program for families with children birth to five. A parent
educator shares child-development information from the National Parents as Teachers
curriculum and an age-appropriate activity each month. The focus of this program is to prepare
children for kindergarten and to provide parent support. Parent group meetings, community
activities, and developmental screenings are offered throughout the year. A learning center is
also available for parent groups and individuals to use, providing children with age-appropriate
learning through play materials.
Eligibility: Children must be between the ages of birth to five years of age. No income eligibility
required.
Coalition for Families-Sister Love
Service description: An infant mortality reduction initiative for African-American women of
childbearing ability. Program focus includes: health education, group support activities, incentive
programs, home visitation, exercise component, and community outreach.
Eligibility: Must be an African-American woman of childbearing ability
Hours: Monday-Friday, 8:30 a.m.-5:00 p.m.
Teen Pregnancy Prevention/Adolescent Parenting Programs
Service description: Pregnancy Prevention - During and after-school classes are held for
middle and high school students to learn about good decision making, taking responsibility, etc.
Service learning and field trips also are provided. New referrals are taken each school year.
Adolescent Parenting is for pregnant and parenting teens that are staying in school. Referrals
are taken anytime. Group sessions that focus on daily life issues are held during school days.
Individual home visits also are made on a monthly basis to teach parenting skills.
Eligibility: Pregnancy prevention: An at-risk teen in middle or high school.
Adolescent parenting: must be pregnant or parent teens in school. (Public or private)
Languages: English and Spanish with some limitations.
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Reach Out Crisis Pregnancy Center
Contact: Renee Haugh, Executive Director
Phone: (919) 898-2923
Located: 1565 Gulf Road, Suite B
Gulf, NC 27256
Gulf, NC 27256
Fax: (919) 898-2924
Description: Earn While You Learn program, abstinence education, post-abortion counseling,
adoption as option counseling, peer counseling, parenting information sharing, and material
support.
Fees: All services are free for the client.
Conclusions Drawn:
Review of the information shows there are voids in health services for the residents of Lee
County as evidenced in this section and also from information shared in chapters three and four.
Medical Resources:
Number of dentists, registered nurses and physician assistants has been declining while the
population continues to increase.
Discussions with hospital administration showed that since the 2008 data was reported, the
county has increased the number of surgeons and has received various awards and
recognitions for the services provided.
Health Department: The number of staff in both direct services in the clinic and in health
promotion is limited. Since 2006, 14 critical positions have been lost. These positions include
staff such as four dental health staff while this is now listed as one of the top five priority health
issues for the County. Other positions are: Public Health Preparedness Coordinator, Health
Education Specialist, two nurses, one Physician Extender, two Health Check Coordinators (bilingual), an Animal Shelter Attendant, Environmental Health Specialist, and a Maternal Outreach
Worker.
Health Promotions: Personnel cuts in this area are evident and limit the ability to do all the
needed/requested health promotions by the Health Department staff.
Mental Health providers at the psychologist level are another area in need of discussion. While
there has been a large increase of service providers since the 2008 information in this chapter,
it appears the number of licensed providers needs to increase.
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There is a void in services available to the population that is not served by the local hospital or
health department due to economic status. Some of the needed services are primary care as
well as dental care for the underserved population. These concerns were expressed in the
listening sessions and supported in the number of decays identified in the charts in chapter four
regarding dental care.
A concerted and unified effort towards health, fitness and nutrition is lacking but, we are moving
towards making Lee County a healthier county to live, work and play. The county is engaged in
a Community Vision Initiative designed to provide a framework for decision makers as our
community sets a course for the future. This task was undertaken as part the Lee County
Second Century Action Plan formulated in 2008. Nine subcommittees, called Vision Teams
have been meeting to develop strategies. The nine Vision Teams are: economic development,
public safety, public health, arts and cultures, ecosystems, growth and transportation, outreach,
education and communication.
The 2010 Community Health Assessment and action plans will play a part in the formulation and
implementation of this initiative. The Lee County Public Health Education Supervisor co-chairs
the Public Health subcommittee along with the CEO for the hospital. LeeCAN plays an integral
part in this committee’s efforts and the top five identified health priorities will become a part of
the overall county effort.
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Chapter
six
DISSEMINATION
PLAN
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2010 Lee County
CHAPTER SIX
Dissemination Plan
Accreditation Activity 1.3 states that the local Health Department shall disseminate results of the
most recent Community Health Assessment (CHA) to local health department stakeholders,
community partners, and general populations. To that end, the Lee County Health Department
and LeeCAN “A Healthy Carolinians Partnership” will disseminate the 2010 Community Health
Assessment accordingly. A publicity committee comprised of health educators and LeeCAN
partners has outlined the procedure to disseminate the CHA once it is completed. The plan is
as follows:
Publication
Publish the document using a variety of media formats: hard copy, CD, electronic
version for websites
Develop a press release and a Public Service Announcement (PSA)
Prepare a PowerPoint presentation that can be posted electronically and used for
presentations to multiple groups.
Prepare and publish an Executive Summary that is a brief document highlighting key
points drawn from the CHA.
Presentations
Presentation to the Lee County Board of Health
Share Press release and public service announcement with selected/key public officials
present
Newspaper feature article “Health Matters” column in the Sanford Herald and an article
in HomeTown News
Presentations to other groups such as:
o LeeCAN full partnership meeting
o Lee County Board of Education and the school district Healthy Education
Advisory Council
o Chamber of Commerce
o Lee County Board of Commissioners
o Local civic groups
o Other groups and businesses, upon request
Radio and TV shows such as local TV station’s “Alive at Nine” program
Dissemination
Public service announcement (PSA) to local radio stations
Hard copies of the document will be distributed to the Board of Health, Health
Department, Chamber of Commerce, Central Carolina Hospital, city and town mayors’
offices, Lee County Schools district office, area NC House and Senate representatives,
LeeCAN office, local public library (along with a CD version), and others as requested.
At least three hard copies and CDs will be available for check out at the Community
Health Education and LeeCAN offices.
The complete report will be accessible for download from the Health Department’s
website.
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An electronic version will be placed on the city, county, and Chamber of Commerce
websites.
The PowerPoint presentation also will be available from the county website and other
locations.
The Executive Summary, and other documents as feasible, will be translated into
Spanish, Lee County’s second most spoken language.
The Executive Summary will be widely disseminated at all LeeCAN and Health
Department functions and LeeCAN/Health Department exhibits such as the local Lee
Regional Fair and the State Healthy Carolinians Conference.
The Executive Summary will be mailed to all community leaders, local agencies and
organizations, and given to all LeeCAN partners, along with members of the Health
Department staff.
English/ Spanish versions will be available for clients of the Health Department.
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Chapter
seven
Conclusions
AND
NEXT STEPS
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2010 Lee County
CHAPTER SEVEN
Next Steps: Community Action Planning
The Lee County Health Department and LeeCAN “A Healthy Carolinians Partnership”
Community Health Assessment consisted of primary and secondary health data to identify the
Healthy Carolinians Objectives of highest priority for the county. The LeeCAN Assessment
Team met with 36 community leaders to begin the process of prioritizing Lee County’s health
issues with future plans to develop action plans aligned with the 2020 Healthy Carolinians
Health Objectives. The assessment team presented to the community leaders the top 10
Health Concerns and Community Needs that were gathered during the survey and Listening
Sessions which include:
•
•
•
•
•
•
•
•
•
•
Aging problems
Cancer
Dental health
Diabetes
Heart disease/heart attack
Hypertension/high blood pressure
Mental health
Obesity/overweight
Sexually Transmitted Infections
Teen pregnancy
To select the top five priorities, participants were given secret ballots and asked to select the
five areas that they determined to be priority issues over the next four years. The areas selected
were: (1) Access to mental health, (2) Dental health, (3) Obesity/overweight, (4) Sexually
Transmitted Infections and (5) Teen pregnancy. These priorities will carry the same weight
since the five areas will be addressed over the next four years.
LeeCAN “A Healthy Carolinians Partnership” will continue to recruit and identify additional
community partners including strong community-based representation. Once the CHA has
been printed and distributed into the community, LeeCAN Partnership will begin working on the
Action Plans based on the five priorities for 2011 – 2015.
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Appendices
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2010 Lee County
Appendix A1
“A Healthy Carolinians Partnership”
Moderator/Facilitator Training for Listening Session
Lee Community Art Center
Room 314
Wednesday, January 27, 2010
11:30 am – 1:00 pm
(Lunch will be served)
Agenda
Welcome
Brief overview of the Community Health Assessment
Training
Questions & Answers
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2010 Lee County
Appendix A2
Listening Session Agenda
5:30pm-7:30pm
(Dinner provided and served at the beginning)
Welcome and Introduction
Overview of CHA
(Arrange participants in a circle)
Ground Rules and Confidentiality
Group Introductions
Begin Group Questions
(Do not share your opinion and monitor your body language.)
Ask for Additional Comments at the end
Brief on LeeCAN and the 3 current priority areas
Questions and Answers
Thank the participants
106
2010 Lee County
Appendix A3
Moderator “Cheat Sheet”
Introduction
Thank you so much for being a part of our listening session group for the Community Health
Assessment.
The information that we gather here today will be vital in helping determining and addressing health
issues and community issues in Lee County.
Overview of CHA
The CHA is done every four years, in partnership with Healthy Carolinians. Basically they ask the
community to evaluate their own needs, and determine what the community feels are concerns, versus
someone from outside the community trying to assess the needs.
Any questions?
General Ground Rules
**The purpose of the listening session is to receive honest opinions of members of the community**
Everyone should agree that thoughts, views, opinions, and feelings shared during the focus group are
confidential. We want everyone’s participation. We ask that one person speak at a time, because we
want to be sure and accurately capture everyone’s responses. We want everyone to have the
opportunity to be heard and to be comfortable sharing their views.
Confidentiality
Everything said during our listening session is confidential, no names will be recorded; only the
responses. We expect that everyone participating respect the other participants and keep what is said
in the listening session confidential.
Group Intros: Names ***Remember the Name tags; this will make it easier for you to address the
participants during listening session questions and question and answering.
Begin Group Questions:
*The moderator must remember to be aware of their own body language, facial expressions, and
head nodding, smiling, or nostril flaring.
• Avoid answering questions during questioning.
• Do not speak too much. Do not lead the participants.
• Try not to let anyone dominate.
• This should be done ‘round-robin style’.
• Remember: do not record names
Additional Comments
Brief sharing of LeeCAN current focus issues
Access to mental health
Obesity
Teen pregnancy
Questions and Answers
107
2010 Lee County
Appendix B1
CHA Priority Meeting
April 7, 2010
AGENDA
Introductions
Background of CHA – Process and Timeline
Purpose of the Meeting
Survey, Focus Groups, and Local Data Information
Discussion and Priority Selection
Conclusion and Next Steps
108
2010 Lee County
Appendix B2
Community Health Assessment Priority Meeting
Priority Setting Ballot
April 7, 2010
Directions:
Please review the list of the top 10 health priorities as identified in the Community Health
Assessment and the Focus Groups. These are not in a priority order.
Based on the information provided and your own thoughts, please place a check mark in what
you consider the top 5 health issues we should address in our report, plans, and task force
work over the next four years.
This information will be compiled and you will receive notice of the overall top 5. We
appreciate your attendance and participation in this very important meeting and process.
Health Priority Listing
Your Five Selections
(do not rank )
Aging Problems
Cancer
Dental Health
Diabetes
Heart Disease/Heart Attack
High Blood Pressure
Mental Health
Obesity
Sexually Transmitted Disease
Teen Pregnancy
109
2010 Lee County
Appendix B3
CHA Stakeholders Health Priorities Meeting: April 7, 2010
*Those who actually attended.
NAME
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
Annie Lanier McIver *
Rhi Anna Stephens*
Brandi Phillips *
Brittany McBryde *
Bob Stevens *
Amanda Johnson*
Dr. David Fisher
Betty Seawell
Mary Hawley Oates *
Phyllis Watson *
Laura Biediger *
Jan Hayes *
13. Fidel Hernandez*
14. Laura Spivey *
15. Linda Swann *
16.
17.
18.
19.
20.
21.
22.
23.
Marilyn Gilliam *
Sandra Coombs *
Sandra Petty *
Silvia Bayer *
Richard B. Hayes *
Larry Oldham
Linda Kelly*
Johnnye Waller*
24. Dr. Lyn Smith*
25. Tracy Carter(Rep. from
his office)*
26. Regina McCoy Pullian*
27. Pam Glover *
28. Sandra Boyd *
29. Howard Surface
30. Wendy Seymore *
31. Elsie Ramsey *
32. Linda Higgins *
AREA/POSITION
Faith Based
DayMark Recovery
Lee Co. Parks & Rec.
Broadway Town Manager
Dentist/ Board of Health
HR Analyst
Lee County Schools/Nurse Sup.
Communities In Schools
Ex. Director United Way of Lee
County
Lee County Schools/Migrant
Recruiter
City of Sanford/Public Works
Sandhills Center LME Family
Support
VC& Associates
LeeCAN co-chair/faith based
Sanford Housing Authority
Lee County Schools/coordinator
Lee County Commissioner (Chair)
Lee County Commissioner
Board of Health
Lee County Schools-Director of
Students Services
Dentist – Lee County Board of
Education
Lee County Sheriff
Associate Professor – UNC-G
Health Department Health Educator
Health Dept. Health Education Sup.
Health Department Director
NC Dental Health Hygienist
UNC-G Student Intern
LeeCAN Coordinator
110
SIGNATURE
2010 Lee County
Appendix C
2010 Lee County Community Health Assessment Partner Involvement
Name
Title
Organization
Role in CHA
Sandra Boyd
Health Education Supervisor
Department, LeeCAN
Overall Assessment Team, Listening
Session Moderator
Linda Higgins
LeeCAN Coordinator
Healthy Carolinians
Overall Assessment Team
Pamela Glover
Health Education Specialist, Task Force
Chair person
Department, LeeCAN
Public Health Intern
UNC-Greensboro
NC Department of Public Health,
LeeCAN
Department
Session Moderator
Session Moderator
Elsie Ramsey
Wendy
Seymore
Howard
Surface
Charles
Sutherland
Sandra
Coombs
NC Dental Hygienist
Public Health Director
Concerned Citizen, LeeCAN ,
Co-chairperson
Retired Military, LeeCAN
LeeCAN Assessment Team
Parish Nurse, LeeCAN Co-Chairperson
Recreation Programmer, LeeCAN
Secretary
Adolescent Pregnancy Prevention
Coordinator
Quality Management Director, Task
Force Chairperson
Former Program Coordinator & Task
Force Chairperson
Crossroads Ministries, LeeCAN
Lee County Parks and Recreation,
LeeCAN
Coalition for Families in Lee
County, LeeCAN
LeeCAN Assessment Team, Listening
Session Moderator
Extension Agent, 4-H Youth Development
Faith-based representative
NC Cooperative Extension, LeeCAN
Cameron Grove AME Zion Church,
LeeCAN
Mary B. Oates
Lee County Schools Nurse Supervisor
Lee County Schools, LeeCAN
Listening Session Moderator/Facilitator
Kate Nelson
Nursing student Intern
Lee County Schools
Josie Ceves
Nursing student Intern
Lee County Schools
Marvin Morris
Karen Brown
Concerned Citizen
Realtor
ERA Realty, LeeCAN
Jan Hayes
Michele
Bullard
Executive Director
United Way of Lee County, LeeCAN
Program Services Director
United Way of Lee County, LeeCAN
Office Assistant
Director of Special
Services/Programs(retired)
Health Educator
Copying, photos, general office duties for
CHA
Director of Public Affairs
Central Carolina Hospital
Brandi Phillips
Brittany
McBryde
Marilyn
Gilliam
Laura Biediger
Bill Stone
Annie Lanier
McIver
Linda Holder
Pam Patterson
Emily Tyler
Margaret
Minuth
VC & Associates, LeeCAN
Communities In Schools, LeeCAN
Lee County Schools
Retired
111
Session Moderator
Session Moderator
Proofreading
Proofreading
CHA information, research and data
analysis

community health assessment

Transcription

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